Consenso sobre la clasificación de la enfermedad vascular pulmonar hipertensiva en niños: Reporte del task force pediátrico del Pulmonary Vascular Research Institute (PVRI) Panamá 2011

OpenAIRE

Jesús del Cerro, María; Abman, Steven; Díaz, Gabriel; Heath Freudenthal, Alexandra; Freudenthal, Franz; Harikrishnan, S.; Haworth, Sheila G.; Ivy, Dunbar; Lopes, Antonio A.; Usha Raj, J.; Sandoval, Julio; Stenmark, Kurt; Adatia, Ian; Lammers, Astrid E.

2012-01-01

Las clasificaciones actuales de la hipertensión pulmonar han contribuido significativamente al conocimiento de la enfermedad vascular pulmonar, han facilitado ensayos farmacológicos y han mejorado nuestro conocimiento de las cardiopatías congénitas del adulto; sin embargo estas clasificaciones no son aplicables completamente a la enfermedad en el niño. La clasificación que aquí se propone se basa principalmente en la práctica clínica. Los objetivos específicos de esta nueva clasificación son ...

Presurgical fMRI evaluation of cerebral reorganization and motor deficit in patients with tumors and vascular malformations

International Nuclear Information System (INIS)

Baciu, M.; Le Bas, J.F.; Segebarth, C.; Benabid, A.L.

2003-01-01

The aim of this fMRI study was to evaluate the motor reorganization (cerebral plasticity) and the risk of motor deficit in patients presenting with tumors and vascular malformations, within the framework of their pre-surgical planning. Functional MR imaging data was obtained from 17 patients. Ten patients (seven with tumors and three with vascular malformations) presented with motor reorganization. The results of the present study suggest that the evaluation of the cerebral reorganization is an essential step in predicting the risk of motor deficit in patients having surgical indication for treatment. Furthermore, the cerebral reorganization constitutes an important factor for surgical decision

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

Institute of Scientific and Technical Information of China (English)

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

2014-01-01

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

Post-mortem assessment of hypoperfusion of cerebral cortex in Alzheimer's disease and vascular dementia.

Science.gov (United States)

Thomas, Taya; Miners, Scott; Love, Seth

2015-04-01

Perfusion is reduced in the cerebral neocortex in Alzheimer's disease. We have explored some of the mechanisms, by measurement of perfusion-sensitive and disease-related proteins in post-mortem tissue from Alzheimer's disease, vascular dementia and age-matched control brains. To distinguish physiological from pathological reduction in perfusion (i.e. reduction exceeding the decline in metabolic demand), we measured the concentration of vascular endothelial growth factor (VEGF), a protein induced under conditions of tissue hypoxia through the actions of hypoxia-inducible factors, and the myelin associated glycoprotein to proteolipid protein 1 (MAG:PLP1) ratio, which declines in chronically hypoperfused brain tissue. To evaluate possible mechanisms of hypoperfusion, we also measured the levels of amyloid-β40, amyloid-β42, von Willebrand factor (VWF; a measure of microvascular density) and the potent vasoconstrictor endothelin 1 (EDN1); we assayed the activity of angiotensin I converting enzyme (ACE), which catalyses the production of another potent vasoconstrictor, angiotensin II; and we scored the severity of arteriolosclerotic small vessel disease and cerebral amyloid angiopathy, and determined the Braak tangle stage. VEGF was markedly increased in frontal and parahippocampal cortex in Alzheimer's disease but only slightly and not significantly in vascular dementia. In frontal cortex the MAG:PLP1 ratio was significantly reduced in Alzheimer's disease and even more so in vascular dementia. VEGF but not MAG:PLP1 increased with Alzheimer's disease severity, as measured by Braak tangle stage, and correlated with amyloid-β42 and amyloid-β42: amyloid-β40 but not amyloid-β40. Although MAG:PLP1 tended to be lowest in cortex from patients with severe small vessel disease or cerebral amyloid angiopathy, neither VEGF nor MAG:PLP1 correlated significantly with the severity of structural vascular pathology (small vessel disease, cerebral amyloid angiopathy or VWF

Case of radiation necrosis with vascular changes on main cerebral arteries

Energy Technology Data Exchange (ETDEWEB)

Ishibashi, Y; Okada, H; Mineura, K; Kodama, N [Tohoku Univ., Sendai (Japan). School of Medicine

1982-03-01

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

Cerebral Vascular Disease and Neurovascular Injury in Ischemic Stroke

Science.gov (United States)

Hu, Xiaoming; De Silva, T. Michael; Chen, Jun; Faraci, Frank M.

2017-01-01

The consequences of cerebrovascular disease are among the leading health issues worldwide. Large and small cerebral vessel disease can trigger stroke and contribute to the vascular component of other forms of neurological dysfunction and degeneration. Both forms of vascular disease are driven by diverse risk factors, with hypertension as the leading contributor. Despite the importance of neurovascular disease and subsequent injury following ischemic events, fundamental knowledge in these areas lag behind our current understanding of neuroprotection and vascular biology in general. The goal of this review is to address select key structural and functional changes in the vasculature that promote hypoperfusion and ischemia, while also affecting the extent of injury and effectiveness of therapy. In addition, as damage to the blood-brain barrier (BBB) is one of the major consequences of ischemia, we discuss cellular and molecular mechanisms underlying ischemia-induced changes in BBB integrity and function, including alterations in endothelial cells and the contribution of pericytes, immune cells, and matrix metalloproteinases. Identification of cell types, pathways, and molecules that control vascular changes before and after ischemia may result in novel approaches to slow the progression of cerebrovascular disease and lessen both the frequency and impact of ischemic events. PMID:28154097

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

International Nuclear Information System (INIS)

Kawahata, Nobuya; Gotoh, Chiharu; Yokoyama, Sakura; Daitoh, Nobuyuki

2001-01-01

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

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

DEFF Research Database (Denmark)

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

2017-01-01

OBJECTIVE Vascular permeability and iron leakage are central features of cerebral cavernous malformation (CCM) pathogenesis. The authors aimed to correlate prospective clinical behavior of CCM lesions with longitudinal changes in biomarkers of dynamic contrast-enhanced quantitative permeability (...

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

Science.gov (United States)

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

2010-11-19

Acetazolamide (ACZ) was used to stimulate the cerebral vasculature on ten healthy volunteers to assess the cerebral vasomotor reactivity (CVR). We have combined near infrared spectroscopy (NIRS), diffuse correlation spectroscopy (DCS) and transcranial Doppler (TCD) technologies to non-invasively assess CVR in real-time by measuring oxy- and deoxy-hemoglobin concentrations, using NIRS, local cerebral blood flow (CBF), using DCS, and blood flow velocity (CBFV) in the middle cerebral artery, using TCD. Robust and persistent increases in oxy-hemoglobin concentration, CBF and CBFV were observed. A significant agreement was found between macro-vascular (TCD) and micro-vascular (DCS) hemodynamics, between the NIRS and TCD data, and also within NIRS and DCS results. The relative cerebral metabolic rate of oxygen, rCMRO(2), was also determined, and no significant change was observed. Our results showed that the combined diffuse optics-ultrasound technique is viable to follow (CVR) and rCMRO(2) changes in adults, continuously, at the bed-side and in real time.

Cerebral blood flow single-photon emission tomography with {sup 123}I-IMP in vascular dementia

Energy Technology Data Exchange (ETDEWEB)

Kawahata, Nobuya; Gotoh, Chiharu; Yokoyama, Sakura; Daitoh, Nobuyuki [Narita Memorial Hospital, Toyohashi, Aichi (Japan)

2001-06-01

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

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

International Nuclear Information System (INIS)

Claus, J.J.; Breteler, M.M.B.; Hasan, D.; Krenning, E.P.; Bots, M.L.; Grobbee, D.E.; Swieten, J.C. van; Harskamp, F. van; Hofman, A.

1996-01-01

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

Nutrición del Niño con Enfermedades Neurológicas Prevalentes: An Update

OpenAIRE

LE ROY O, CATALINA; REBOLLO G, MARÍA JESÚS; MORAGA M, FRANCISCO; DÍAZ SM, XIMENA; CASTILLO-DURÁN, CARLOS

2010-01-01

En este artículo se revisan algunas enfermedades neurológicas en donde el manejo nutricional tiene un rol relevante, como son la parálisis cerebral, epilepsia, autismo y síndrome de déficit atencional (SDAH). La nutrición frecuentemente es afectada en niños con parálisis cerebral por factores como la enfermedad de base, la dificultad en ingerir alimentos por alteraciones sensoriales, motoras y/o gastrointestinales y las deficiencias nutricionales específicas relacionadas con la ingesta insufi...

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

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2001-01-01

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

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

International Nuclear Information System (INIS)

Ishibashi, Yasuhiko; Okada, Hitoshi; Mineura, Katsuyoshi; Kodama, Namio

1982-01-01

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

Consenso sobre la clasificación de la enfermedad vascular pulmonar hipertensiva en niños: reporte del task force pediátrico del Pulmonary Vascular Research Institute (PVRI Panamá 2011 A consensus approach to the classification of pediatric pulmonary hypertensive vascular disease: Report from the PVRI Pediatric Taskforce, Panama 2011

Directory of Open Access Journals (Sweden)

María Jesús del Cerro

2012-12-01

Full Text Available Las clasificaciones actuales de la hipertensión pulmonar han contribuido significativamente al conocimiento de la enfermedad vascular pulmonar, han facilitado ensayos farmacológicos y han mejorado nuestro conocimiento de las cardiopatías congénitas del adulto; sin embargo estas clasificaciones no son aplicables completamente a la enfermedad en el niño. La clasificación que aquí se propone se basa principalmente en la práctica clínica. Los objetivos específicos de esta nueva clasificación son mejorar las estrategias diagnósticas, promover la investigación clínica, mejorar nuestro conocimiento de la patogénesis, de la fisiología y de la epidemiología de la enfermedad y orientar el desarrollo de modelos de la enfermedad humana en el laboratorio y estudios en animales; también puede servir como un recurso docente. Se hace énfasis en los conceptos de maladaptación perinatal, alteraciones del desarrollo e hipoplasia pulmonar como factores causantes de la hipertensión pulmonar pediátrica; así mismo, en la importancia de los múltiples síndromes malformativos congénitos, genéticos y cromosómicos en la presentación de la hipertensión pulmonar pediátrica. La enfermedad vascular pulmonar hipertensiva en niños se divide en diez grandes categorías.Current classifications of pulmonary hypertension have contributed a great deal to our understanding of pulmonary vascular disease, facilitated drug trials, and improved our understanding of congenital heart disease in adult survivors. However, these classifications are not applicable readily to pediatric disease. The classification system that we propose is based firmly in clinical practice. The specific aims of this new system are to improve diagnostic strategies, to promote appropriate clinical investigation, to improve our understanding of disease pathogenesis, physiology and epidemiology, and to guide the development of human disease models in laboratory and animal studies. It

Central Pulsatile Pressure and Flow Relationship in the Time and Frequency Domain to Characterise Hydraulic Input to the Brain and Cerebral Vascular Impedance.

Science.gov (United States)

Kim, Mi Ok; O'Rourke, Michael F; Adji, Audrey; Avolio, Alberto P

2016-01-01

In the time domain, pulsatile flow and pressure can be characterised as the ratio of the late systolic boost of flow or pressure to the pulse amplitude so as to estimate the hydraulic input to the brain. While vascular impedance has been widely used to represent the load presented to the heart by the systemic circulation, it has not been applied to the cerebral circulation.We set out to study the relationship between the pressure and the flow augmentation index (AIx) in the time domain and to determine cerebral vascular impedance using aortic blood pressure and cerebral blood flow waveforms in the frequency domain. Twenty-four young subjects (aged 21-39 years) were recruited; aortic pressure was derived using SphygmoCor from radial pressure. Flow waveforms were recorded from the middle cerebral artery. In three subjects, we performed the Valsalva manoeuvre to investigate their response to physiological intervention. There was a linear relationship between flow and pressure AIx, and cerebral impedance values were similar to those estimated for low resistance vascular beds. Substantial change in pressure and flow wave contour was observed during the Valsalva manoeuvre; however, the relationship in both the time and the frequency domains were unchanged. This confirms that aortic pressure and cerebral flow waveform can be used to study cerebral impedance.

La mortalidad por enfermedades del corazón y por reumatismo en la ciudad de bogotá

OpenAIRE

Bejarano, Jorge

2012-01-01

La alta cifra de mortalidad por enfermedades cardio-vasculares está indicando la urgencia de una campana para contener sus avances. De todas las adquisiciones sanitarias, ninguna ha tenido el alcance y los resultados admirables de los centros o dispensarios destinados al tratamiento de una enfermedad y a la educación del enfermo. Nadie podrá pues, dudar que los dispensarios o consultorios de enfermedades cardio-vasculares, sea una de las armas más eficaces en la lucha contra la mortalidad por...

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

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Carlos A. M. Guerreiro

1984-12-01

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

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

International Nuclear Information System (INIS)

Liu Hui; Zhang Xintang; Wang Jin; Tian Min; He Yuping; Zhao Jinqi; He Qian; Chen Huanjun; Li Fawei

2012-01-01

Objective: To investigate CT features on increased cerebral vascular density and its pathological mechanism in patients with cyanotic congenital heart disease (CCHD). Methods: Preoperative brain CT scan and clinical data in 82 patients suffering from CCHD were analyzed. According to the increased levels of vascular density, patients were divided into 4 groups: normal, mild, moderate and severe. Relationships between the increased levels of vascular density and Hb, RBC, HCT, as well as the degree of cyanosis,were studied. AVONA was carried out to test blood CT value of cerebral sinuses, Hb, RBC and HCT in different groups. Descriptive analysis and linear regression were adopted to study the correlation between blood CT value and Hb concentration. The relationship of increased vascular density to degrees of cyanosis was analysed by Spearman. Results: Among 82 patients, 12 patients (14.6%) were found in the group of normal vascular density and 70 patients (85.4%) in the increased vascular density group. Among 70 patients with increased vascular density, 22 patients (26.8% ) with (55.4 ± 2.6) HU, (169 ±6)g/L of Hb, (5.8 ±0.3) × 10 12 /L of RBC and 0.51 ±0.03 of HCT, 29 patients (35.4%) with (61.3 ± 2.9) HU, (209 ± 15 ) g/L, (7.1 ± 0.4) × 10 12 /L, 0.66 ± 0.06 and 19 patients (23.2%) with (68.8 ± 4.2) HU, (242 ± 23) g/L, (8.3 ± 0.9) × 10 12 /L, 0.78 ± 0.08 were observed in the mild,moderate and severe group,respectively. There were significant differences in distribution of blood CT value (HU), Hb, RBC and HCT in different groups (F=163.263, 134.703, 120.974, 136.541; P<0.01). Blood CT value was positively correlated with Hb concentration (r=0.98, P<0.01). Vascular density was also positively correlated with the degree of cyanosis (r=0.86, P<0.01). Conclusions: Cerebral vascular density of patients suffering from CCHD presented different levels of increases based on CT scan results due to rise of RBC stimulated by anoxia. The increased level of vascular

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

Science.gov (United States)

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

2017-06-01

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

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

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Katherine eBangen

2014-07-01

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

Placental growth factor deficiency is associated with impaired cerebral vascular development in mice.

Science.gov (United States)

Luna, Rayana Leal; Kay, Vanessa R; Rätsep, Matthew T; Khalaj, Kasra; Bidarimath, Mallikarjun; Peterson, Nichole; Carmeliet, Peter; Jin, Albert; Croy, B Anne

2016-02-01

Placental growth factor (PGF) is expressed in the developing mouse brain and contributes to vascularization and vessel patterning. PGF is dynamically expressed in fetal mouse brain, particularly forebrain, and is essential for normal cerebrovascular development. PGF rises in maternal plasma over normal human and mouse pregnancy but is low in many women with the acute onset hypertensive syndrome, pre-eclampsia (PE). Little is known about the expression of PGF in the fetus during PE. Pgf  (-/-) mice appear normal but recently cerebral vascular defects were documented in adult Pgf  (-/-) mice. Here, temporal-spatial expression of PGF is mapped in normal fetal mouse brains and cerebral vasculature development is compared between normal and congenic Pgf  (-/-) fetuses to assess the actions of PGF during cerebrovascular development. Pgf/PGF, Vegfa/VEGF, Vegf receptor (Vegfr)1 and Vegfr2 expression were examined in the brains of embryonic day (E)12.5, 14.5, 16.5 and 18.5 C57BL/6 (B6) mice using quantitative PCR and immunohistochemistry. The cerebral vasculature was compared between Pgf  (-/-) and B6 embryonic and adult brains using whole mount techniques. Vulnerability to cerebral ischemia was investigated using a left common carotid ligation assay. Pgf/PGF and Vegfr1 are highly expressed in E12.5-14.5 forebrain relative to VEGF and Vegfr2. Vegfa/VEGF is relatively more abundant in hindbrain (HB). PGF and VEGF expression were similar in midbrain. Delayed HB vascularization was seen at E10.5 and 11.5 in Pgf  (-/-) brains. At E14.5, Pgf  (-/-) circle of Willis showed unilateral hypoplasia and fewer collateral vessels, defects that persisted post-natally. Functionally, adult Pgf  (-/-) mice experienced cerebral ischemia after left common carotid arterial occlusion while B6 mice did not. Since Pgf  (-/-) mice were used, consequences of complete absence of maternal and fetal PGF were defined. Therefore, the effects of maternal versus fetal PGF

Morbimortalidad por enfermedad cerebrovascular de tipo isquémica Morbimortality from ischemic stroke

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Adianis González González

2007-12-01

Full Text Available Las enfermedades cerebrovasculares constituyen la tercera causa de muerte en Cuba y en la mayoría de los países desarrollados. Tiene estrecha relación su aparición y tórpida evolución con la existencia de enfermedades o factores de riesgo como: diabetes mellitus, hipertensión arterial, enfermedades cardíacas, accidentes vasculares encefálicos previos, tabaquismo y obesidad. La isquemia cerebral constituye la causa de la mayoría de los ictus, tanto de tipo trombótico como embólico; sus consecuencias causan postración e incapacidad. Se realizó un estudio transversal y descriptivo de aquellos pacientes admitidos en la Sala de Cuidados Especiales del Hospital “General Calixto García” en el período de enero a julio de 2006, con diagnóstico de enfermedad cerebrovascular, para identificar los factores de riesgo más frecuentes, evaluar los protocolos de actuación, definir grado de incapacidad al egreso, así como las causas más frecuentes de muerte. Encontramos que la enfermedad tuvo mayor incidencia en la 7ma. y 8va. décadas de la vida, los factores de riesgo más frecuentes fueron la hipertensión arterial y el antecedente de enfermedad cerebrovascular previa, los protocolos de actuación no fueron cumplidos debidamente por múltiples causas. Solo un 26,2 % estaba asintomático al alta desde el punto de vista funcional, el resto presentaba algún tipo de discapacidad. La causa de muerte más frecuente fue extraneurológica.Strokes are the third cause of death in Cuba and in most of the developed countries. Its appearance and torpid evolution are closely related to the existence of diseases or risk factors, such as: diabetes mellitus, arterial hypertension, previous vascular encephalic accidents, smoking and obesity. Ischemic stroke is the cause of most of thrombotic and embolic strokes, whose consequences are prostration and disability. A cross-sectional descriptive study of those patients admitted in the special care ward of

Genetic modification of cerebral arterial wall: implications for prevention and treatment of cerebral vasospasm.

Science.gov (United States)

Vijay, Anantha; Santhanam, R; Katusic, Zvonimir S

2006-10-01

Genetic modification of cerebral vessels represents a promising and novel approach for prevention and/or treatment of various cerebral vascular disorders, including cerebral vasospasm. In this review, we focus on the current understanding of the use of gene transfer to the cerebral arteries for prevention and/or treatment of cerebral vasospasm following subarachnoid hemorrhage (SAH). We also discuss the recent developments in vascular therapeutics, involving the autologous use of progenitor cells for repair of damaged vessels, as well as a cell-based gene delivery approach for the prevention and treatment of cerebral vasospasm.

Prenatal diagnosis of concurrent facial and cerebral vascular malformation which caused congestive heart failure

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Behnaz Moradi

2017-12-01

Full Text Available Arteriovenous malformations (AVMs are rarely reported antenatally. Most in utero diagnosis of vascular malformation is related to vein of Galen malformation (VGM. We describe a case of simultaneously diagnosed pial arteriovenous fistula (AVF and facial vascular malformation in a 20 weeks old fetus. The dilated intracranial venous pouch appeared as a midline anechoic structure which was misdiagnosed as a VGM in her previous ultrasound exam. Another AVM was diagnosed in the same side of fetal face which fed by a branch of external carotid artery and communicated with the mentioned pial AVF. High output cardiac failure and hydrops were evident. To our knowledge this is the first report of prenatally detected combination of facial and cerebral vascular malformations at such as early pregnancy week.

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

DEFF Research Database (Denmark)

Hempel, Casper; Hoyer, Nils; Kildemoes, Anna

2014-01-01

The pathogenesis of cerebral malaria (CM) includes compromised microvascular perfusion, increased inflammation, cytoadhesion, and endothelial activation. These events cause blood-brain barrier disruption and neuropathology and associations with the vascular endothelial growth factor (VEGF) signal...

Anestesia e paralisia cerebral Anestesia y parálisis cerebral Anesthesia and cerebral palsy

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Március Vinícius M Maranhão

2005-12-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: A paralisia cerebral (PC é uma doença não progressiva decorrente de lesão no sistema nervoso central, levando a um comprometimento motor do paciente. O portador de PC freqüentemente é submetido a procedimentos cirúrgicos devido a doenças usuais e situações particulares decorrentes da paralisia cerebral. Foi objetivo deste artigo revisar aspectos da paralisia cerebral de interesse para o anestesiologista, permitindo um adequado manuseio pré, intra e pós-operatório neste tipo de paciente. CONTEÚDO: O artigo aborda aspectos da paralisia cerebral como etiologia, classificação, fatores de risco, fisiopatologia, quadro clínico, diagnóstico, terapêuticas utilizadas bem como avaliação pré-operatória, medicação pré-anestésica, manuseio intra e pós-operatório, analgesia pós-operatória e dor crônica. CONCLUSÕES: O anestesiologista desempenha um papel importante na diminuição da morbidade e mortalidade anestésico-cirúrgica em pacientes portadores de paralisia cerebral. O conhecimento da fisiopatologia dos diferentes tipos de paralisia cerebral bem como das doenças associadas e suas terapêuticas é imprescindível, pois permite ao anestesiologista antecipar e prevenir complicações intra e pós-operatórias neste tipo de paciente.JUSTIFICATIVA Y OBJETIVOS: La parálisis cerebral (PC es una enfermedad no progresiva consecuente de una lesión en el sistema nervioso central, llevando a un comprometimiento motor del paciente. El portador de PC, frecuentemente es sometido a procedimientos quirúrgicos debido a enfermedades usuales y situaciones particulares consecuentes de la parálisis cerebral. El objetivo de este artículo, fue revisar aspectos de la parálisis cerebral de interés para el anestesista, permitiendo un adecuado manoseo pre, intra y posoperatorio en este tipo de paciente. CONTENIDO: El artículo aborda aspectos de la parálisis cerebral como etiología, clasificación, factores de

Cortical Cerebral Microinfarcts on 3 Tesla MRI in Patients with Vascular Cognitive Impairment.

Science.gov (United States)

Ferro, Doeschka A; van Veluw, Susanne J; Koek, Huiberdina L; Exalto, Lieza G; Biessels, Geert Jan

2017-01-01

Cerebral microinfarcts (CMIs) are small ischemic lesions that are a common neuropathological finding in patients with stroke or dementia. CMIs in the cortex can now be detected in vivo on 3 Tesla MRI. To determine the occurrence of CMIs and associated clinical features in patients with possible vascular cognitive impairment (VCI). 182 memory-clinic patients (mean age 71.4±10.6, 55% male) with vascular injury on brain MRI (i.e., possible VCI) underwent a standardized work-up including 3 Tesla MRI and cognitive assessment. A control group consisted of 70 cognitively normal subjects (mean age 70.6±4.7, 60% male). Cortical CMIs and other neuroimaging markers of vascular brain injury were rated according to established criteria. Occurrence of CMIs was higher (20%) in patients compared to controls (10%). Among patients, the presence of CMIs was associated with male sex, history of stroke, infarcts, and white matter hyperintensities. CMI presence was also associated with a diagnosis of vascular dementia and reduced performance in multiple cognitive domains. CMIs on 3 Tesla MRI are common in patients with possible VCI and co-occur with imaging markers of small and large vessel disease, likely reflecting a heterogeneous etiology. CMIs are associated with worse cognitive performance, independent of other markers of vascular brain injury.

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

International Nuclear Information System (INIS)

Michaelson, S.M.; Kramer, M.W.

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

Cerebral infarcts resulting from trauma

International Nuclear Information System (INIS)

Busch, G.

1985-01-01

Vascular occlusions due to cerebral trauma have always been regarded as great rarities. However, we have found hypo-dense foci of vascular distribution in 3.5% of 3500 CT examinations for trauma during the late phase. Lesions in the vascular territory of the posterior cerebral artery are usually the result of supratentorial pressure rise from epidural and subdural haematomas, leading to compression of the vessels against the edge of the tentorium. Typical infacts in the territory of the medial and anterior cerebral arteries were found only rarely by CT after cerebral trauma. Infarcts at the watersheds between the three vascular territories were found with surprising frequency and small infarcts were found in the basal ganglia. It is assumed that these were due to ischaemic or hypoxic events due to cardiac or pulmonary complications during the initial phase. (orig.) [de

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

International Nuclear Information System (INIS)

Frechou, M.; Beray-Berthat, V.; Plotkine, M.; Marchand-Leroux, C.; Margaill, I.; Raynaud, J.S.; Gombert, F.; Lancelot, E.; Ballet, S.; Robert, P.; Louin, G.; Meriaux, S.

2013-01-01

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

Cerebral vascular structure in the motor cortex of adult mice is stable and is not altered by voluntary exercise.

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Cudmore, Robert H; Dougherty, Sarah E; Linden, David J

2017-12-01

The cerebral vasculature provides blood flow throughout the brain, and local changes in blood flow are regulated to match the metabolic demands of the active brain regions. This neurovascular coupling is mediated by real-time changes in vessel diameter and depends on the underlying vascular network structure. Neurovascular structure is configured during development by genetic and activity-dependent factors. In adulthood, it can be altered by experiences such as prolonged hypoxia, sensory deprivation and seizure. Here, we have sought to determine whether exercise could alter cerebral vascular structure in the adult mouse. We performed repeated in vivo two-photon imaging in the motor cortex of adult transgenic mice expressing membrane-anchored green fluorescent protein in endothelial cells (tyrosine endothelial kinase 2 receptor (Tie2)-Cre:mTmG). This strategy allows for high-resolution imaging of the vessel walls throughout the lifespan. Vascular structure, as measured by capillary branch point number and position, segment diameter and length remained stable over a time scale of months as did pericyte number and position. Furthermore, we compared the vascular structure before, during, and after periods of voluntary wheel running and found no alterations in these same parameters. In both running and control mice, we observed a low rate of capillary segment subtraction. Interestingly, these rare subtraction events preferentially remove short vascular loops.

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

International Nuclear Information System (INIS)

Kimura, Mahito; Shimoda, Kengo; Mizumura, Sunao; Tateno, Amane; Fujito, Tatsuma; Mori, Takao; Endo, Shunkichi

2003-01-01

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

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

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Someya Nami

2012-06-01

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

Majewski osteodysplastic primordial dwarfism type II (MOPD II) complicated by stroke: clinical report and review of cerebral vascular anomalies.

Science.gov (United States)

Brancati, Francesco; Castori, Marco; Mingarelli, Rita; Dallapiccola, Bruno

2005-12-15

We report on a 2 9/12-year-old boy with disproportionate short stature, microcephaly, subtle craniofacial dysmorphisms, and generalized skeletal dysplasia, who developed a left hemiparesis. Brain neuroimaging disclosed a complex cerebral vascular anomaly (CVA) with stenosis of the right anterior cerebral artery and telangiectatic collateral vessels supplying the cerebral cortex, consistent with moyamoya disease. Based on clinical and skeletal features, a diagnosis of Majewski osteodysplastic primordial dwarfism type II (MOPD II) was established. Review of 16 published patients with CVA affected by either Seckel syndrome or MOPD II suggested that CVA is preferentially associated to the latter subtype affecting about 1/4 of the patients. 2005 Wiley-Liss, Inc.

Cerebral vascular disease in Hiroshima. Report of a six-year period of surveillance, 1958 to 1964

Energy Technology Data Exchange (ETDEWEB)

Johnson, K G; Yano, Katsuhiko; Kato, Hiroo

1966-08-25

Cerebral vascular disease (CVD) in the population of Hiroshima, Japan, is described for the period 1958 to 1964. The incidence of CVD in the male population over 30 years of age was 7.4 per 1000 per year and in females 4.1, approximately twice the observed incidence of coronary heart disease. Being based on examined individuals only, these estimates are biased downward, perhaps by a factor of 10%. The frequency of cerebral thrombosis was twice that of cerebral hemorrhage. These findings on incidence and type of CVD are in accord with the known high incidence of this disease in Japan but do not suggest that any disease other than atherosclerosis of the cerebral arteries is responsible. Hypertension, cardiomegaly (ascertained by ECG or chest film), and proteinuria were important factors in the risk of subsequent CVD. The singular association between hypertension and CVD, and the evidence that CVD is declining in Japan, the US and Europe during a period of widespread use of antihypertensive agents, encourage further epidemiologic study in CVD. 30 references, 15 figures, 8 tables.

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

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Scott Paul J

2005-01-01

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

Can vascular risk factors influence number and size of cerebral metastases? A 3D-MRI study in patients with different tumor entities.

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Nagel, Sandra; Berk, Benjamin-Andreas; Kortmann, Rolf-Dieter; Hoffmann, Karl-Titus; Seidel, Clemens

2018-02-01

There is increasing evidence that cerebral microangiopathy reduces number of brain metastases. Aim of this study was to analyse if vascular risk factors (arterial hypertension, diabetes mellitus, smoking, and hypercholesterolemia) or the presence of peripheral arterial occlusive disease (PAOD) can have an impact on number or size of brain metastases. 200 patients with pre-therapeutic 3D-brain MRI and available clinical data were analyzed retrospectively. Mean number of metastases (NoM) and mean diameter of metastases (mDM) were compared between patients with/without vascular risk factors (vasRF). No general correlation of vascular risk factors with brain metastases was found in this monocentric analysis of a patient cohort with several tumor types. Arterial hypertension, diabetes mellitus, hypercholesterolemia and smoking did not show an effect in uni- and multivariate analysis. In patients with PAOD the number of BM was lower than without PAOD. This was the case independent from cerebral microangiopathy but did not persist in multivariate analysis. From this first screening approach vascular risk factors do not appear to strongly influence brain metastasation. However, larger prospective multi-centric studies with better characterized severity of vascular risk are needed to more accurately detect effects of individual factors. Copyright © 2018 Elsevier B.V. All rights reserved.

La prevención primaria con aspirina de enfermedades cardiovasculares en personas diabéticas. Revisión de las pruebas disponibles

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Carmen Maciá Bobes

2006-01-01

Full Text Available El beneficio del tratamiento con aspirina en la reducción del riesgo de infarto de miocardio, accidente vascular cerebral y muerte de origen vascular, está bien documentado en personas con enfermedad cardiovascular previa, incluido el subgrupo portador de una diabetes mellitus. Sin embargo el papel de la aspirina en prevención primaria es menos claro y objeto de discusión: los resultados de los ensayos clínicos disponibles no son consistentes, aunque los meta-análisis son favorables en algunos aspectos. Parece existir una disparidad entre el tipo de beneficio (cuando se observa y el sexo. Y en particular los resultados son contradictorios en personas diabéticas, las cuales representan un pequeño porcentaje de la muestra de población incluida en los estudios. A pesar de esto, la American Diabetes Association desde 1997, y otras sociedades científicas (incluidas varias españolas desde tiempos más recientes, recomiendan el uso de aspirina a dosis bajas en prevención primaria en todo paciente diabético mayor de 40 años, tipo 1 o tipo 2; y en todos los menores de 40 y mayores de 21 años que presenten otro factor de riesgo cardiovascular, además de la diabetes (antecedentes familiares de enfermedad vascular, hipertensión arterial, tabaquismo, dislipidemia o albuminuria. En este trabajo se revisan los resultados de los ensayos clínicos randomizados y controlados sobre la prevención cardiovascular primaria con aspirina, en los que se podrían apoyar las directrices oficiales de la American Diabetes Association, y se llega a la conclusión de que no existen actualmente pruebas científicas suficientes para sostenerlas.

Enfermedad de Alzheimer

OpenAIRE

Serrano Reyes, Carlos Daniel; Fundación Valle de Lili

2001-01-01

¿Cuáles son las manifestaciones de la enfermedad de Alzheimer?/ Signos de alarma de la enfermedad de Alzheimer/ ¿Cómo se diagnostica la enfermedad?/ ¿Cómo se trata la enfermedad de Alzheimer?/ ¿Qué se está investigando sobre la enfermedad?/ ¿Qué otras enfermedades se parecen al Alzheimer?

Repercussão do acidente vascular cerebral na aprendizagem da criança

OpenAIRE

Sonia das Dores Rodrigues

2008-01-01

Resumo: A doença cerebrovascular (DCV) é considerada rara na infância, com incidência aproximada de 2.3 a 2.5/100.000 crianças/ano. Comparando-se aos estudos realizados na idade adulta, na infância os estudos ainda são raros e, em geral, a idéia passada pela literatura é que essa doença não traz maiores repercussões para o futuro desses indivíduos. Entretanto, pesquisas realizadas a partir da última década, principalmente, vêm demonstrando que o acidente vascular cerebral (AVC) pode compromet...

Cerebral vascular effects of hypovolemia and dopamine infusions

DEFF Research Database (Denmark)

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

2012-01-01

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

Enfermedad de Parkinson

OpenAIRE

Orozco V., Jorge Luis; Fundación Valle de Lili

2002-01-01

¿Qué tan frecuente es la enfermedad de Parkinson?/ ¿Qué ocasiona la enfermedad?/ ¿Existen otras formas de Parkinsonismo?/ ¿Quién desarrolla la enfermedad de Parkinson?/ ¿Cuales son los síntomas principales?/ ¿Cómo se diagnostica la enfermedad de Parkinson?/ ¿Cómo se trata la enfermedad?/Tratamiento quirúrgico/Aspectos prácticos del tratamiento/Verdades sobre la enfermedad de Parkinson.

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

International Nuclear Information System (INIS)

Miyakawa, Kouichi; Watanabe, Sho; Suzuki, Michiyo; Kamijima, Gonbei

1989-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2015-08-03

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

Dynamic digitized cerebral parenchymography

International Nuclear Information System (INIS)

Theron, J.; Alachkar, F.; Nelson, M.; Mazia, D.

1992-01-01

Aortic arch injections centred on the head have been performed routinely in patients with cerebral ischaemia. Digital angiograms with modified windowing (low and narrow) have been used. This 'cerebral' arch injection allows much improved analysis of the cerebral parenchymal vascularization, giving better understanding of hemispheric ischaemia and making the decision about revascularization more rational. (orig.)

Single Sustained Inflation followed by Ventilation Leads to Rapid Cardiorespiratory Recovery but Causes Cerebral Vascular Leakage in Asphyxiated Near-Term Lambs.

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Kristina S Sobotka

Full Text Available A sustained inflation (SI rapidly restores cardiac function in asphyxic, bradycardic newborns but its effects on cerebral haemodynamics and brain injury are unknown. We determined the effect of different SI strategies on carotid blood flow (CaBF and cerebral vascular integrity in asphyxiated near-term lambs.Lambs were instrumented and delivered at 139 ± 2 d gestation and asphyxia was induced by delaying ventilation onset. Lambs were randomised to receive 5 consecutive 3 s SI (multiple SI; n = 6, a single 30 s SI (single SI; n = 6 or conventional ventilation (no SI; n = 6. Ventilation continued for 30 min in all lambs while CaBF and respiratory function parameters were recorded. Brains were assessed for gross histopathology and vascular leakage.CaBF increased more rapidly and to a greater extent during a single SI (p = 0.01, which then decreased below both other groups by 10 min, due to a higher cerebral oxygen delivery (p = 0.01. Blood brain barrier disruption was increased in single SI lambs as indicated by increased numbers of blood vessel profiles with plasma protein extravasation (p = 0.001 in the cerebral cortex. There were no differences in CaBF or cerebral oxygen delivery between the multiple SI and no SI lambs.Ventilation with an initial single 30 s SI improves circulatory recovery, but is associated with greater disruption of blood brain barrier function, which may exacerbate brain injury suffered by asphyxiated newborns. This injury may occur as a direct result of the initial SI or to the higher tidal volumes delivered during subsequent ventilation.

Relationship of serum S1P and HC-II levels with vasoactive substances and cytokines in patients with cerebral vascular restenosis after stent implantation

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Yong Liu

2017-04-01

Full Text Available Objective: To study the relationship of serum sphingosine 1-phosphate (S1P and heparin cofactor II (HCII levels with vasoactive substances and cytokines in patients with cerebral vascular restenosis after stent implantation. Methods: 52 patients who received cerebrovascular stent implantation and developed restenosis in our hospital between May 2012 and December 2015 were collected as observation group, and 40 healthy patients with cerebrovascular stent implantation who had re-examination in our hospital during the same period were selected as control group. ELISA method was used to detect serum S1P and HC-II levels as well as vasoactive substance and inflammatory factor contents. Spearman correlation analysis was used to evaluate the relationship of serum S1P and HC-II levels with vasoactive substances and inflammatory factors. Results: Serum S1P and HC-II levels of observation group were lower than those of control group (P<0.05; serum vasoactive substances endothelin (ET, angiotensin II (AngII and thromboxane B2 (TXB2 contents of observation group were higher than those of control group while nitric oxide (NO content was lower than that of control group (P<0.05; serum inflammatory factors hypersensitive C-reactive protein (hs-CRP, interleukin-1 (IL-1, IL-6, IL-8 and IL-11 contents of observation group were higher than those of control group (P<0.05. Serum S1P and HC-II levels in patients with cerebral vascular restenosis after stent implantation were directly correlated with vasoactive substance and inflammatory factor contents. Conclusion: Serum S1P and HC-II levels decrease in patients with cerebral vascular restenosis after stent implantation, and it is an important cause of cerebral vascular dysfunction and systemic inflammatory response.

Clinical application of cerebral dynamic perfusion studies

International Nuclear Information System (INIS)

DeLand, F.H.

1975-01-01

Radionuclide cerebral perfusion studies are assuming a far greater importance in the detection and differential diagnosis of cerebral lesions. Perfusion studies not only contribute to the differential diagnosis of lesions but in certain cases are the preferred methods by which more accurate clinical interpretations can be made. The characteristic blood flow of arterio-venous malformations readily differentiates this lesion from neoplasms. The decreased perfusion or absent perfusion observed in cerebral infarctions is diagnostic without concurrent evidence from static images. Changes in rates and direction of blood flow contribute fundamental information to the status of stenosis and vascular occlusion and, in addition, offer valuable information on the competency and routes of collateral circulation. The degree of cerebral perfusion after cerebral vascular accidents appears to be directly related to patient recovery, particularly muscular function. Cerebral perfusion adds a new parameter in the diagnosis of subdural haematomas and concussion and in the differentiation of obscuring radioactivity from superficial trauma. Although pictorial displays of perfusion blood flow will offer information in most cerebral vascular problems, the addition of computer analysis better defines temporal relationships of regional blood flow, quantitative changes in flow and the detection of the more subtle increases or decreases in cerebral blood flow. The status of radionuclide cerebral perfusion studies has taken on an importance making it the primary modality for the diagnosis of cerebral lesions. (author)

In vivo evidence for long-term vascular remodeling resulting from chronic cerebral hypoperfusion in mice

OpenAIRE

Struys, Tom; Govaerts, Kristof; Oosterlinck, Wouter; Casteels, Cindy; Bronckaers, Annelies; Koole, Michel; Van Laere, Koen; Herijgers, Paul; Lambrichts, Ivo; Himmelreich, Uwe; Dresselaers, Tom

2016-01-01

We have characterized both acute and long-term vascular and metabolic effects of unilateral common carotid artery occlusion in mice by in vivo magnetic resonance imaging and positron emission tomography. This common carotid artery occlusion model induces chronic cerebral hypoperfusion and is therefore relevant to both preclinical stroke studies, where it serves as a control condition for a commonly used mouse model of ischemic stroke, and neurodegeneration, as chronic hypoperfusion is causati...

Monitoring of cerebral haemodynamics in newborn infants

DEFF Research Database (Denmark)

Liem, K Djien; Greisen, Gorm

2010-01-01

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

Masaje circulatorio superficial en la enfermedad arterial periférica

OpenAIRE

Cebrià Iranzo, M. Àngels

2010-01-01

En la enfermedad arterial periférica crónica se indica el masaje circulatorio superficial por producir una vasodilatación refleja en las zonas afectadas. Este masaje manual tiene dos objetivos fundamentales: 1) Favorecer la vasodilatación refleja e hiperemia local; 2) Drenar el retorno vascular sanguíneo y linfático.

Panax ginseng extract attenuates neuronal injury and cognitive deficits in rats with vascular dementia induced by chronic cerebral hypoperfusion

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Jun-De Zhu

2018-01-01

Full Text Available Panax ginseng is a slow-growing perennial plant. Panax ginseng extract has numerous biological activities, including antitumor, anti-inflammatory and antistress activities. Panax ginseng extract also has a cognition-enhancing effect in rats with alcohol-induced memory impairment. In this study, we partially occluded the bilateral carotid arteries in the rat to induce chronic cerebral hypoperfusion, a well-known model of vascular dementia. The rats were then intragastrically administered 50 or 100 mg/kg Panax ginseng extract. Morris water maze and balance beam tests were used to evaluate memory deficits and motor function, respectively. Protein quantity was used to evaluate cholinergic neurons. Immunofluorescence staining was used to assess the number of glial fibrillary acidic protein-positive cells. Western blot assay was used to evaluate protein levels of vascular endothelial growth factor, basic fibroblast growth factor, Bcl-2 and Bax. Treatment with Panax ginseng extract for 8 weeks significantly improved behavioral function and increased neuronal density and VEGF and bFGF protein expression in the hippocampal CA3 area. Furthermore, Panax ginseng extract reduced the number of glial fibrillary acidic protein-immunoreactive cells, and it decreased apoptosis by upregulating Bcl-2 and downregulating Bax protein expression. The effect of Panax ginseng extract was dose-dependent and similar to that of nimodipine, a commonly used drug for the treatment of vascular dementia. These findings suggest that Panax ginseng extract is neuroprotective against vascular dementia induced by chronic cerebral hypoperfusion, and therefore might have therapeutic potential for preventing and treating the disease.

El anisakis y sus enfermedades como enfermedad profesional

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José Manuel Vicente Pardo

Full Text Available El anisakis es un parásito complejo de los animales marinos. El hombre no es el hospedador adecuado, ya que en él la larva L3 no puede completar su ciclo vital, siendo por tanto un hospedador accidental u ocasional, que se interpone en el ciclo vital del nemátodo, y al que el anisakis le puede causar tanto la parasitación como la alergia, cuando ingiere pescado o cefalópodos crudos o poco cocinados: tales como sushi, sashimi, ceviche gravlax noruego, lomi-lomi hawaiano, así como pescados en escabeche, vinagre, desecado, ahumados, semiconservas, o en salazón que contengan este parásito en su forma de larva en estadio tres L3. Las enfermedades por anisakis constituyen un problema de salud pública, generalizado y que ha aumentado su incidencia en los últimos años. En 2012, se notificaron 20.000 casos de anisakiasis en todo el mundo. España es el segundo país con mayor número de intoxicaciones por Anisakis después de Japón. Diversos estudios en España sobre la prevalencia de la sensibilización reflejan una elevada prevalencia entre pacientes que han sufrido episodios de reacciones alérgicas. El 50 por ciento de quienes manipulan directamente el pescado presentan sensibilidad a anisakis. Siendo por tanto cada vez más común la afectación por y en el desarrollo del trabajo, constituyendo entonces procesos considerados como enfermedad profesional cuando se dan las circunstancias determinantes causales de trabajo, riesgo y exposición que para ello deben concurrir. La afección puede presentarse tanto por contacto laboral como por contacto en el consumo ordinario de pescado infestado, lo que hará difícil el estimar como causa exclusiva o consecuente la aparición de la enfermedad a consecuencia del desempeño del trabajo. Los sectores laborales de riesgo por enfermedades por anisakis, son los pescadores, pescaderos ("pescateros" y cocineros. En general todos aquellos que trabajan tanto en la captura, limpieza, manipulación, venta

Evidencias de compromiso cerebral en el estadio crónico de la enfermedad de Chagas obtenidas por medio del potencial P300 y de electroencefalografía cuantificada

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PROST JULIO OSCAR

2000-01-01

Full Text Available Es reconocido el compromiso del sistema nervioso periférico en la etapa crónica de la enfermedad de Chagas, incorporándose últimamente evidencias tomográficas y neuropsicológicas de compromiso cerebral. Con el objetivo de evaluar dicho compromiso por medio del potencial P 300 y la electroencefalografía cuantificada (EEGc se estudiaron 35 pacientes (26 a 55 años, comparados con un grupo control de similar número y edad (29 a 55 años. Se observó: latencia de la onda P 3 mayor en el grupo en estudio (331,24 ± 24,02 contra 318,86 ± 23,18 (p=0,01716. El EEGc mostró diferencias en la potencia relativa de la banda Beta 1, menor en los pacientes (p=1,62834E5 y en la frecuencia dominante, 1 Hz menor en los chagasicos (p=0,01077. El análisis multivariado discrimina tres subpoblaciones: una normal, una de enfermos con incremento alfa y otra de enfermos con decremento alfa e incremento delta y theta (p=0,00004. La proporción de resultados patológicos fue del 20 % en los EEGc y el 11,43 % en los potenciales cognitivos. No se correlacionó el compromiso neurológico y el cardíaco. Se concluye que existen francos indicadores electrofisiológicos de compromiso cerebral en el estadio crónico de la enfermedad de Chagas, hallazgo que refuerza a los obtenidos por otros métodos.

mTOR drives cerebral blood flow and memory deficits in LDLR-/- mice modeling atherosclerosis and vascular cognitive impairment.

Science.gov (United States)

Jahrling, Jordan B; Lin, Ai-Ling; DeRosa, Nicholas; Hussong, Stacy A; Van Skike, Candice E; Girotti, Milena; Javors, Martin; Zhao, Qingwei; Maslin, Leigh Ann; Asmis, Reto; Galvan, Veronica

2018-01-01

We recently showed that mTOR attenuation blocks progression and abrogates established cognitive deficits in Alzheimer's disease (AD) mouse models. These outcomes were associated with the restoration of cerebral blood flow (CBF) and brain vascular density (BVD) resulting from relief of mTOR inhibition of NO release. Recent reports suggested a role of mTOR in atherosclerosis. Because mTOR drives aging and vascular dysfunction is a universal feature of aging, we hypothesized that mTOR may contribute to brain vascular and cognitive dysfunction associated with atherosclerosis. We measured CBF, BVD, cognitive function, markers of inflammation, and parameters of cardiovascular disease in LDLR -/- mice fed maintenance or high-fat diet ± rapamycin. Cardiovascular pathologies were proportional to severity of brain vascular dysfunction. Aortic atheromas were reduced, CBF and BVD were restored, and cognitive dysfunction was attenuated potentially through reduction in systemic and brain inflammation following chronic mTOR attenuation. Our studies suggest that mTOR regulates vascular integrity and function and that mTOR attenuation may restore neurovascular function and cardiovascular health. Together with our previous studies in AD models, our data suggest mTOR-driven vascular damage may be a mechanism shared by age-associated neurological diseases. Therefore, mTOR attenuation may have promise for treatment of cognitive impairment in atherosclerosis.

Enfermedades de la pobreza, enfermedades tropicales desatendidas

OpenAIRE

Pecoul, Bernard; Alvarado, J.

2014-01-01

Las enfermedades tropicales desatendidas (ETDs) se caracterizan por su altísima incidencia en países de renta baja haciendo bueno el nefasto ciclo pobreza-enfermedad-pobreza. Las ETDs son ajenas al mundo occidental por lo que no son consideradas prioritarias, pero tampoco lo son para los gobiernos de los países endémicos al afectar a las poblaciones rurales sin voz política. Los escasos beneficios que proporcionan los medicamentos para estas enfermedades las hacen poco atractivas para la inve...

Major Vascular Neurocognitive Disorder: A Reappraisal to Vascular Dementia

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Emre Kumral

2017-03-01

Full Text Available Major vascular neurocognitive disorder (NCD is the second leading form of dementia after Alzheimer’s disease, accounting for 17-20% of all dementias. Vascular NCD is a progressive disease caused by reduced cerebral blood flow related to multiple large volume or lacunar infarcts that induce a sudden onset and stepwise decline in cognitive abilities. Despite its prevalence and clinical importance, there is still controversy in the terminology of vascular NCD. Only after the release of Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5 (2013 did the American Psychiatric Association define vascular dementia as “major vascular NCD”. This review includes an overview of risk factors, pathophysiology, types, diagnostic and clinical features of major vascular NCD, and current treatment options of vascular NCD regarding to DSM-5 criteria

Enfermedad acido-peptica

OpenAIRE

Echavarría, Hector Raúl; Fundación Valle de Lili; Mendoza, Alfredo

1999-01-01

¿En qué consisten las enfermedades que se denominan con el término genérico de enfermedad acido-péptica?/ ¿Cuáles son sus síntomas?/ ¿Cómo se comporta la enfermedad acido-péptica y cuáles son sus causas?/ ¿Cómo se evitan estas enfermedades y como se tratan?

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

Science.gov (United States)

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

2016-01-01

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

Propuesta de Plan de Cuidado a la Persona con Aneurisma Cerebral

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Jully Catherine Acevedo Arguello

2012-08-01

Full Text Available Objetivo: Describir el plan de cuidado a la persona con Aneurisma Cerebral. Métodos: Se identificaron los dominios de Enfermería alterados y las necesidades frecuentes en el proceso de salud-enfermedad (Aneurisma Cerebral; también se estableció el juicio (Diagnóstico de enfermería NANDA que orientó la implementación de objetivos (NOC y desarrollo de actividades e intervenciones de enfermería (NIC; todo ello con el fin de brindar cuidados integrales a la persona, la familia y la comunidad, conservar el funcionamiento neurológico y prevenir el riesgo de complicaciones en la persona al cuidado de enfermería con una enfermedad cerebrovascular. Resultados y Conclusiones: Los aneurismas cerebrales son dilataciones localizadas de la pared del vaso arterial y por lo general se encuentran en puntos de bifurcación o en relación con el origen de una rama arterial; todos los aneurismas cerebrales tienen potencial de ruptura y causan complicaciones serias como el accidente cerebro-vascular hemorrágico, situación clínica crítica conocida como hemorragia subaracnoidea. Debido al impacto que tiene dicha patología tanto en la persona, la familia y la comunidad, el profesional de Enfermería requiere fortalecer los conocimientos acerca de la patología, el cuidado propio de Enfermería y desarrollar las habilidades que permitan un cuidado integral de éste tipo de personas. El PAE es una herramienta fundamental utilizada en la práctica asistencial de la disciplina de enfermería. Éste fa vorece la perspectiva del profesional de enfermería hacia la planificación y el desarrollo de cuidados sistematizados, lógicos y racionales centrados en respuestas humanas dentro del proceso de salud-enfermedad, estos cuidados buscan obtener logros tanto en la persona, la familia y la comunidad sana o enferma, permitiendo tener una visión holística en el proceso del cuidado diario tanto en áreas clínicas como comunitarias.

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

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João Sigefredo Arruda

2014-06-01

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

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

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Tania Fernandes Campos

2007-01-01

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

Prognostic significance of MR angiography in patients with cerebral infarction

International Nuclear Information System (INIS)

Moon, Woong Jae; Kim, Jun Ho; Seo, Jeong Jin; Cho, Ki Hyun; Kim, Yun Hyeon; Kim, Jae Kyu; Kang, Heoung Keun

1994-01-01

This study was designed to evaluate the prognostic significance of Magnetic resonance angiography(MRA) in patients with cerebral infarction. Magnetic Resonance Imaging(MRI) and 2 dimensional or 3 dimensional Time-of-Flight MRA were performed subsequently in 83 patients with cerebral infarction proven by brain CT and clinical manifestations, using GE Signa Advantage 1.5 T. We classified the size of infarction on MRI as Extent I( 6 cm) and classified the intracranial vascular occlusion according to visualizations of intracranial vascular branches on MRA as Grade 0, Grade I, Grade II, Grade III. And we evaluated clinical outcomes of these patients according to Rankin's disability scale, compared with MRI and MRA. In 72 cases(86.8%), the larger the size of infarction on MRI, the more severe vascular occlusion on MRA, the worse the clinical outcomes were noted(p < 0.01). However, in 7 cases(8.4%) who showed huge cerebral infarction on MRI with low grade intracranial vascular occlusion on MRA, the clinical outcomes were improved. In 4 cases(4.8%) who noted small sized cerebral infarction on MRI with high grade vascular occlusion on MRA, the clinical outcomes were worsened. MRA provides additional useful information to that provided by MRI in predicting the prognosis of patients with cerebral infarction

Cerebral vascular control and metabolism in heat stress

DEFF Research Database (Denmark)

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

2015-01-01

implications and pathologies known to confound cerebral functioning during hyperthermia. A reduction in cerebral blood flow (CBF), derived primarily from a respiratory-induced alkalosis, underscores the cerebrovascular changes to hyperthermia. Arterial pressures may also become compromised because of reduced...

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

International Nuclear Information System (INIS)

Jung, Han Young; Lee, Hui Joong; Kim, Hye Jung; Kim, Yong Sun; Kang, Duk Sik

2006-01-01

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

The arterial circle of Willis of the mouse helps to decipher secrets of cerebral vascular accidents in the human.

Science.gov (United States)

Okuyama, Shinichi; Okuyama, Jun; Okuyama, Junko; Tamatsu, Yuichi; Shimada, Kazuyuki; Hoshi, Hajime; Iwai, Junichi

2004-01-01

The human brain represents an elaborate product of hominizing evolution. Likewise, its supporting vasculature may also embody evolutionary consequences. Thus, it is conceivable that the human tendency to develop cerebral vascular accidents (CVAs) might represent a disease of hominization. In a search for hominizing changes on the arterial circle of Willis (hWAC), we attempted an anatomical comparison of the hWAC with that of the mouse (mWAC) by injecting aliquots of resin into the vasculature of the mouse and then creating vascular endocasts of the mWAC. The internal carotid artery of the mouse (mICA) unites with the mWAC midway between the middle cerebral artery (mMCA) and posterior cerebral artery (mPCA). The mWAC does not complete a circle: the mWAC nourishes the anterior portion of the circle which branches out to the olfactory artery (OlfA) and mPCA, along with the mMCA, and the basilar artery (mBA) does not connect to the mPCA. The OlfA is thicker than the mMCA. The relative brain weight of the mouse was 74 g on average for a 60 kg male and 86 g for a 60 kg female, respectively, as compared with 1424 g for a 60 kg man. These findings are consistent with the mouse being a nocturnal carnivore that lives on olfactory information in contrast to the human that lives diurnally and depends on visual and auditory information. In man, the human ICA (hICA) unites with the hWAC at a point where the human middle cerebral artery (hMCA) branches out, and thus, blood from the hICA does not flow through the hWAC but drains into the hMCA directly. The hMCA is thicker than the anterior cerebral artery. The hPCA receives blood from the hBA rather than from the hICA, and thus, the entire hWAC forms a closed circuit. Since the hICA drains directly into the hMCA without flowing a distance through the hWAC, the capacitor and equalizer functions of the WAC will be mitigated so much that the resultant hemodynamic changes would render the hMCA more likely to contribute to CVAs. Thus

Aplicativo software para rehabilitación en pacientes con afecciones motoras de la mano

OpenAIRE

Díaz Suárez, Ricardo Andrés; Puello Villamizar, Bárbara Milena; Santamaría Sánchez, Edwin; Van-Strahlen Peña, Francy Juliana

2016-01-01

Existen enfermedades como la parálisis cerebral, la distrofia muscular, el síndrome del túnel del Carpio o los accidentes cerebro vasculares (ACV) que pueden ocasionar afecciones o lesiones que comprometen el sistema locomotor, causando pérdida de la fuerza y trastornos en el movimiento de la mano. Estas enfermedades pueden generar debilidad en la mano produciendo en ella pérdida del movimiento, por tal motivo es necesario que las personas que han sufrido dichas enfermedades deban ser sometid...

The role of shear stress and arteriogenesis in maintaining vascular homeostasis and preventing cerebral atherosclerosis

Directory of Open Access Journals (Sweden)

David Della-Morte

2015-01-01

Full Text Available Shear stress (SS is a biomechanical force that is determined by blood flow, vessel geometry, and fluid viscosity. Although a wide range of known vascular risk factors promote development of atherosclerosis, atherosclerotic changes occur predominately at specific sites within the arterial tree, suggesting a critical role for local factors within the vasculature. Atherosclerotic lesions develop predominantly at branches, bends, and bifurcations in the arterial tree because these sites are exposed to low or disturbed blood flow and low SS. Low SS predisposes arteries to atherosclerosis by causing endothelial dysfunction. A natural system of preexisting cerebral collateral arteries protects against ischemia by bypassing sites of arterial occlusion through a mechanism of arteriogenesis. The main trigger for arteriogenesis is impaired vascular homeostasis (VH in response to local changes in SS induced by ischemia. VH is a critical process for maintaining the physiological function of cerebral circulation. It is regulated through a complex biological system of blood flow hemodynamic and physiological responses to flow changes. Restoration of VH by increasing arteriogenesis and SS may provide a novel therapeutic target for stroke, especially in the elderly, who are more prone to VH impairment. In this review article, we discuss the mechanisms and structures necessary to maintain VH in brain circulation, the role of SS, and risk factors leading to atherosclerosis, including the effects of aging. We also discuss arteriogenesis as an adaptive and protective process in response to ischemic injury, the imaging techniques currently available to evaluate arterogenesis such as magnetic resonance imaging/positron emission tomography (MRI/PET, and the potential therapeutic approaches against ischemic injury that target arteriogenesis.

Cerebral aneurysms – an audit

African Journals Online (AJOL)

Enrique

Abstract. We performed an audit to determine the profile of cerebral aneurysms at the Universitas Hospital Bloem- fontein, the only government hospital with a vascular suite in the Free State and Northern Cape area. Two hun- dred and twenty-three government patients, diagnosed with cerebral aneurysms during the period.

Desintegración de las praxias en la enfermedad de Alzheimer

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Carlos A. Bardeci

1972-03-01

Full Text Available Se describe la sintomatologia clínica, los resultados de métodos auxiliares y de la punción biopsia cerebral de una paciente con enfermedad de Alzheimer. Se analizan los diversos aspectos clínicos, sosteniendose como posible determinar la individualidad clínica de la enfermedad de Alzheimer, dentro del capítulo de las demencias preseniles y su diagnóstico en vida. Las formas de apraxia presentes en esta observación confirman la correlación estrecha que existe entre los distintos niveles de su desintegración, à su relación con las perturbaciones del espacio al cual están genéticamente vinculadas; el espacio euclidiano para la apraxia constructiva, el espacio centrado en el propio cuerpo para la ideomotora y el concreto de manipulación de objetos para la ideatoria.

Análise de custo-efetividade da trombólise com alteplase no Acidente Vascular Cerebral

OpenAIRE

Araújo,Denizar Vianna; Teich,Vanessa; Passos,Roberta Benitez Freitas; Martins,Sheila Cristina Ouriques

2010-01-01

FUNDAMENTO: Acidente Vascular Cerebral (AVC) é a principal causa de óbito no Brasil e pouca informação está disponível sobre custo do tratamento. OBJETIVO: Elaborar análise de custo-efetividade da trombólise no AVC, até três horas após o início dos sintomas, comparando o tratamento com alteplase versus conservador, sob a perspectiva do Sistema Único de Saúde (SUS). MÉTODOS: Modelo de análise de decisão foi desenvolvido para comparar os dois tratamentos. Ciclos foram considerados, durante os q...

Vascular malformations in pediatrics

International Nuclear Information System (INIS)

Reith, W.; Shamdeen, M.G.

2003-01-01

Vascular malformations are the cause of nearly all non-traumatic intracranial hemorrhage in children beyond the neonatal stage. Therefore, any child presenting with spontaneous intracranial hemorrhage should be evaluated for child abuse and for vascular malformations. Intracerebral malformations of the cerebral vasculature include vein of Galen malformations, arteriovenous malformation (AVM), cavernomas, dural arteriovenous fistulas, venous anomalies (DVA), and capillary teleangiectasies. Although a few familial vascular malformation have been reported, the majority are sporadic. Clinical symptoms, diagnostic and therapeutic options are discussed. (orig.) [de

Pathological review of late cerebral radionecrosis

International Nuclear Information System (INIS)

Yoshii, Yoshihiko

2008-01-01

Late cerebral radionecrosis may be considered to be a specific chronic inflammatory response, although it is unknown whether the initial damage by brain irradiation is to an endothelial cell or a glial cell. I discuss the pathological specificity of late cerebral radionecrosis by studying the published literature and a case that I experienced. In late cerebral radionecrosis, there are typical coagulation necrosis areas containing fibrinoid necrosis with occlusion of the lumina and poorly active inflammatory areas with many inflammatory ghost cells, focal perivascular lymphocytes, hyalinized vessels, and telangiectatic vascularization near and in the necrotic tissue, and more active inflammatory areas formed as a partial rim of the reactive zone by perivascular lymphocytes, much vascularization, and glial fibrillary acidic protein (GFAP)-positive astrocytes at the corticomedullary border adjacent to necrotic tissue in the white matter. It is difficult to believe that coagulation necrosis occurs without first disordering the vascular endothelial cells because fibrinoid necrosis is a main feature and a diffusely multiple lesion in late cerebral radionecrosis. Because various histological findings do develop, progress, and extend sporadically at different areas and times in the irradiated field of the brain for a long time after radiation, uncontrolled chronic inflammation containing various cytokine secretions may also play a key role in progression of this radionecrosis. Evaluation of the mechanism of the development/aggravation of late cerebral radionecrosis requires a further study for abnormal cytokine secretions and aberrant inflammatory reactions. (author)

The somatotopic localisation of the descending cortical tract in the cerebral peduncle: a study using MRI of changes following Wallerian degeneration in the cerebral peduncle after a supratentorial vascular lesion

International Nuclear Information System (INIS)

Waragai, M.; Watanabe, H.; Iwabuchi, S.

1994-01-01

We studied the effects of Wallerian degeneration in the cerebral peduncle shown by magnetic resonance imaging (MRI) following a supratentorial vascular lesion, to identify the somatotopic localisation of the descending cortical tracts. Patients with a lesion involving a large area of a cerebral hemisphere has an area of abnormal signal intensity in the whole cerebral peduncle, suggesting Wallerian degeneration of all the whole descending cortical tracts. With a small lesion confined to the precentral gyrus, corona radiata, or posterior limb of the internal capsule there was an abnormal signal at the centre of the peduncle, suggesting degeneration of the precentrospinal tract. Those with a small lesion confined to the paracentral gyrus had an abnormal area slightly lateral to the centre of the peduncle, suggesting degeneration of the parietospinal tract. Patients with a lesion of the parietal or temporal lobes, not including the paracentral or precentral gyri, corona radiata, or the posterior limb of the internal capsule, had an abnormal area laterally in the peduncle, suggesting degeneration of the parietopontine or temporopontine tract. (orig.)

Autoconsumo de hierbas medicinales en usuarios con enfermedades cardio-vasculares en una comuna de Chile

Directory of Open Access Journals (Sweden)

Lizet Veliz-Rojas

2015-09-01

Full Text Available Objetivo: Caracterizar el autoconsumo de hierbas medicinales en usuarios con enfermedades cardiovasculares. Metodología: Estudio de tipo cuantitativo y transversal, con una muestra de 257 personas. Los instrumentos recolectores de datos fueron un cuestionario y la revisión de la ficha clínica. Se utilizó un análisis descriptivo univariante apoyado en SPSS. Resultados: El 80,80% de los encuestados usó hierbas medicinales, y el 72,76% señaló no informar esta práctica al equipo de salud. Las hierbas medicinales más utilizadas para el control de la enfermedad cardiovascular fueron: el limón (20,6% para bajar la presión arterial, la pata de vaca (7% para reducir la glicemia y la alcachofa (3,5% para controlar el colesterol. Conclusiones: La mayoría de los participantes recurrieron a las hierbas medicinales, pese a ser una práctica de autocuidado prevalente, no es informada al equipo de salud. Algunas hierbas utilizadas por la muestra para controlar la enfermedad cardiovascular, están descritas sus usos para otras causas. Esta situación podría reflejar el desconocimiento sobre su utilización. Se sugiere el desarrollo de estrategias para el adecuado uso de las hierbas medicinales en atención primaria, enfocado en la integralidad en salud.

A clinical study of cerebral vaso paralysis during a period of cerebral vasospasm after subarachnoid hemorrhage

International Nuclear Information System (INIS)

Watanabe, Toshiichi; Sasaki, Takehiko; Nakagawara, Jyoji

2011-01-01

We employ the 123 I-infinitum (Imp) single photon emission computed tomography (SPECT) dual table autoradiography (Arg) method and stereotactic extraction estimation (SEE) analysis 7 or 8 days after subarachnoid hemorrhage (SAH) onset to predict cerebral vasospasm. We report new findings of cerebral vasoparalysis during a period of cerebral vasospasm after SAH. From January 1, 2005 to April 30, 2008, we encountered 330 cases of aneurysmal SAH, and treated 285 cases. Of these, 65 were excluded as unsuitable for this study, for reasons such as lack of SPECT data, external decompression, admission over 7 days from SAH onset. We studied 220 cases treated by microsurgical clipping (n=178) or endovascular coil embolization (n=42). Vasoparalysis was defined as a rise in resting cerebral blood flow (CBF) and a loss of vascular reserve on SEE analysis of CBF-SPECT. Vasoparalysis occurred in 15 cases (6.8%). Of these, 9 cases (60.0%) had cerebral hematoma, temporary clips had been used in the operation for 8 cases (53.3%), 9 cases (60.0%) experienced postoperative cerebral infarction, and 3 cases (20.0%) had postoperative convulsions. Vasoparalysis occurs in relation to perioperative cerebral damage. In terms of the loss of vascular reserve following SAH, vasoparalysis resembles hemodynamic cerebral ischemia, although the conditions are quite different. Differentiating between these 2 conditions is important, as different forms of management are required. Dual table ARG and SEE analysis are very useful for the evaluating these 2 conditions. (author)

Cerebral emboli and depressive symptoms in dementia.

NARCIS (Netherlands)

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

2006-01-01

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

Vascular permeability in cerebral cavernous malformations

DEFF Research Database (Denmark)

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

2015-01-01

Patients with the familial form of cerebral cavernous malformations (CCMs) are haploinsufficient for the CCM1, CCM2, or CCM3 gene. Loss of corresponding CCM proteins increases RhoA kinase-mediated endothelial permeability in vitro, and in mouse brains in vivo. A prospective case-controlled observ...

Non-invasive methods for measuring vascular changes in neurovascular headaches

DEFF Research Database (Denmark)

Schytz, Henrik W; Amin, Faisal M; Selb, Juliette

2018-01-01

Vascular changes during spontaneous headache attacks have been studied over the last 30 years. The interest in cerebral vessels in headache research was initially due to the hypothesis of cerebral vessels as the pain source. Here, we review the knowledge gained by measuring the cerebral vasculature...... studies of migraine and other headache disorders do not provide solid evidence for cerebral blood flow velocity changes during spontaneous attacks of migraine headache. SPECT studies have clearly shown cortical vascular changes following migraine aura and the differences between migraine with aura...... compared to migraine without aura. PET studies have shown focal activation in brain structures related to headache, but whether the changes are specific to different primary headaches have yet to be demonstrated. MR angiography has shown precise changes in large cerebral vessels during spontaneous migraine...

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

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Luciene Miranda de Andrade

2009-03-01

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

Cerebral vasculitis associated with Schistosoma mansoni infection

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Camuset Guillaume

2012-09-01

Full Text Available Abstract Background Cerebral involvement in schistosomiasis is not rare, but it is underdiagnosed because of the lack of clinical suspicion and the frequency of asymptomatic forms. Neurologic complications are generally supported by granuloma formation around ectopic eggs which have migrated to the brain. Moreover, vascular lesions and cerebral arteritis have been well documented in histopathological studies. Nevertheless, cerebral vasculitis in later stages of the Schistosoma mansoni infection have not yet been described in living subjects. Case presentation A 28-year-old french woman had a stroke linked with cerebral vasculitis, 6 monthes after returning from Burkina-Faso. At the same time, a S. mansoni disseminated infection was diagnosed. She suffered from a new stroke after undertaking praziquantel therapy, which lead us to associate the S. mansoni infection and cerebral vasculitis. Conclusion This is the first report of such association, since cerebral vasculitis has never been described in later stages of the S. mansoni infection. Although the causal link between the two pathologies could not be proved, we suggest that S. mansoni is able to cause severe vascular damage in cerebral vessels. Schistosomiasis must be investigated in the event of a brain infarct in young people, particularly in patients originating or returning from an endemic area.

Indian-ink perfusion based method for reconstructing continuous vascular networks in whole mouse brain.

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Songchao Xue

Full Text Available The topology of the cerebral vasculature, which is the energy transport corridor of the brain, can be used to study cerebral circulatory pathways. Limited by the restrictions of the vascular markers and imaging methods, studies on cerebral vascular structure now mainly focus on either observation of the macro vessels in a whole brain or imaging of the micro vessels in a small region. Simultaneous vascular studies of arteries, veins and capillaries have not been achieved in the whole brain of mammals. Here, we have combined the improved gelatin-Indian ink vessel perfusion process with Micro-Optical Sectioning Tomography for imaging the vessel network of an entire mouse brain. With 17 days of work, an integral dataset for the entire cerebral vessels was acquired. The voxel resolution is 0.35×0.4×2.0 µm(3 for the whole brain. Besides the observations of fine and complex vascular networks in the reconstructed slices and entire brain views, a representative continuous vascular tracking has been demonstrated in the deep thalamus. This study provided an effective method for studying the entire macro and micro vascular networks of mouse brain simultaneously.

Comportamiento de la cognición y comorbilidad en pacientes con infarto cerebral hospitalizados. Seychelles 2010-2011

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Armando Carlos Roca Socarras

2012-10-01

Full Text Available Fundamento: el deterioro cognitivo y la alta comorbilidad son problemas de salud frecuentes en pacientes con enfermedad cerebrovascular. Objetivo: describir el comportamiento del deterioro cognitivo y de la comorbilidad en pacientes con infarto cerebral hospitalizados. Método: estudio descriptivo de 77 pacientes con diagnóstico de enfermedad cerebrovascular isquémica, ingresados entre abril del 2010 y diciembre del 2011, en el hospital general de Seychelles. Se analizó el comportamiento de esta enfermedad en relación con variables como: edad, presencia de enfermedades crónicas no transmisibles, deterioro cognitivo, años de estudios terminados, hemisferio cerebral afectado y tiempo de evolución. Resultados: el 68,9 % de los pacientes presentó deterior cognitivo; la edad media de estos fue de 74,2(±9,19 años frente a un 62,4(±14,2 para los que no tuvieron deterioro cognitivo. Se encontró una mayor frecuencia de enfermedades crónicas no transmisibles en los pacientes con deterioro cognitivo, con un índice de comorbilidad de Charlson en 2,11(±0,97. Se diagnosticaron con depresión 18 pacientes con deterioro cognitivo y 23 pacientes sin deterioro cognitivo. Conclusiones: más de la mitad de los pacientes hospitalizados presentó deterioro cognitivo, la mayor parte previo a la enfermedad cerebrovascular. En este grupo de pacientes predominó el sexo masculino, se observó un incremento de la edad, de la severidad de la depresión, así como de la frecuencia de enfermedades crónicas no transmisibles, e infarto de tamaño considerable, con respecto a los pacientes sin deterioro cognitivo.

La hipermocisteinemia un factor de riesgo de enfermedad cardiovascular, fácil de modificar

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Beatriz E. Meneses Londoño

2002-01-01

Full Text Available The homicysteine (hcy, is an intermedia metabolity in the transformation of metionine to cysteine. Metabolic elimination of these substance depends on vitamins B6, B12 and folic acid and enzymes such like cistationine -sintase, and metilentetrahidrofolate reductase. The common denominators in heredity deficiency of one fo these enzymes or the ones taking part of the metabolism of the folate or the vitamin B12 are a significant raise of Hcy in blood and cardiovascular diseases. Since these observations, they began to relate the Hcy vith vascular disease. Researches in the last two decades point a moderate raise of Hcy as a risk factor in vascular alterations. This metabolity for mechanisms including activation of some ciagulation factors and inactivation of natural anticoagulants helps the thrombi forming and vascular endothelium damage. The raise of this substance is easy to midify through drug and diet media. Due to this, the Hcy takes part of an analytic parameter of growing use in clinical practice, in cardiovascular diseases patients, in the diagnosis and motitorizing of the response to anemia treatment caused by lack of vitamins B12 and/or folic acid, the value of the risk of having defects of the neural tube or espontaneus abortion, specially in cases where they are repetitive. A homocisteína (hcy, es un metabolito intermediario en la conversión de metionina a cisteína. La eliminación metabólica de esta sustancia es dependiente de las vitaminas B6, B12 y ácido fólico y de enzimas tales como la cistationina -sintasa, metionina sintasa y metilenotetrahidrofolato reductasa. Los denominadores comunes en las deficiencias hereditarias de una de estas enzimas o de las que intervienen en metabolismo del folato o de la vitamina B12 son el aumento severo de Hcy en sangre y las enfermedades cardiovasculares. A partir de estas observaciones, se empezó a relacionar Hcy en sangre y las enfermedades cardiovasculares. A partir de estas

Vascular and parenchymal amyloid pathology in an Alzheimer disease knock-in mouse model: interplay with cerebral blood flow.

Science.gov (United States)

Li, Hongmei; Guo, Qinxi; Inoue, Taeko; Polito, Vinicia A; Tabuchi, Katsuhiko; Hammer, Robert E; Pautler, Robia G; Taffet, George E; Zheng, Hui

2014-08-09

Accumulation and deposition of β-amyloid peptides (Aβ) in the brain is a central event in the pathogenesis of Alzheimer's disease (AD). Besides the parenchymal pathology, Aβ is known to undergo active transport across the blood-brain barrier and cerebral amyloid angiopathy (CAA) is a prominent feature in the majority of AD. Although impaired cerebral blood flow (CBF) has been implicated in faulty Aβ transport and clearance, and cerebral hypoperfusion can exist in the pre-clinical phase of Alzheimer's disease (AD), it is still unclear whether it is one of the causal factors for AD pathogenesis, or an early consequence of a multi-factor condition that would lead to AD at late stage. To study the potential interaction between faulty CBF and amyloid accumulation in clinical-relevant situation, we generated a new amyloid precursor protein (APP) knock-in allele that expresses humanized Aβ and a Dutch mutation in addition to Swedish/London mutations and compared this line with an equivalent knock-in line but in the absence of the Dutch mutation, both crossed onto the PS1M146V knock-in background. Introduction of the Dutch mutation results in robust CAA and parenchymal Aβ pathology, age-dependent reduction of spatial learning and memory deficits, and CBF reduction as detected by fMRI. Direct manipulation of CBF by transverse aortic constriction surgery on the left common carotid artery caused differential changes in CBF in the anterior and middle region of the cortex, where it is reduced on the left side and increased on the right side. However these perturbations in CBF resulted in the same effect: both significantly exacerbate CAA and amyloid pathology. Our study reveals a direct and positive link between vascular and parenchymal Aβ; both can be modulated by CBF. The new APP knock-in mouse model recapitulates many symptoms of AD including progressive vascular and parenchymal Aβ pathology and behavioral deficits in the absence of APP overexpression.

Cerebral monitoring during carotid endarterectomy – a comparison ...

African Journals Online (AJOL)

All patients had general anaesthesia and were operated on by the same vascular surgeon (JvM). All patients were evaluated preoperatively by an experienced sonographer. Cerebral monitoring during carotid endarterectomy – a comparison between electroencephalography, transcranial cerebral oximetry and carotid ...

Control integrado del marchitamiento vascular del clavel ocasionado por Fusarium oxysporum f.sp. dianthi

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León Jorge

1993-06-01

Full Text Available Las enfermedades vasculares del clavel, ocasionadas,
principalmente, por Fusarium oxysporumf.sp. dianthi, y en menor grado por Phialophora cinerescens, constituyen un factor limitante del cultivo del clavel en Colombia. Estas enfermedades se introdujeron aColombia, en material de propagación infectado, procedente de diversos paIses desde hace más de quince anos, y su incidencia ha aumentado progresivamente, ocasionando pérdidas muy importantes y con un incremento muy significativo de los costos de producción. La alta incidencia de las enfermedades vasculares
se debe a su fácil propagación a través de esquejes
infectados, a su rápida diseminación por formas diversas, a la alta persistencia del patógeno en el suelo y al alto costo y la baja eficiencia de las medidas de control utilizadas (Arbeláez, 1987a.

Reduced cerebral vascularization in experimental neuronopathic Gaucher disease.

Science.gov (United States)

Smith, Nicholas Jc; Fuller, Maria; Saville, Jennifer T; Cox, Timothy M

2018-01-01

The glycosphingolipidosis, Gaucher disease, in which a range of neurological manifestations occur, results from a deficiency of acid β-glucocerebrosidase, with subsequent accumulation of β-glucocerebroside, its upstream substrates, and the non-acylated congener β-glucosylsphingosine. However, the mechanisms by which end-organ dysfunction arise are poorly understood. Here, we report strikingly diminished cerebral microvascular density in a murine model of disease, and provide a detailed analysis of the accompanying cerebral glycosphingolipidome in these animals, with marked elevations of β-glucosylsphingosine. Further in vitro studies confirmed a concentration-dependent impairment of endothelial cytokinesis upon exposure to quasi-pathological concentrations of β-glucosylsphingosine. These findings support a premise for pathogenic disruption of cerebral angiogenesis as an end-organ effect, with potential for therapeutic modulation in neuronopathic Gaucher disease. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

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

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Rosalina Aparecida Partezani Rodrigues

2013-02-01

Full Text Available OBJECTIVE: to examine the transition of care in families caring for elderly persons who suffered the first episode of a cerebrovascular accident. METHODOLOGY: an instrumental ethnographic case study was used. The sample comprised 20 subjects: 10 caregivers and 10 elderly persons aged 65 or over, of both sexes, with diagnoses of first episode of cerebrovascular accident, capable of communicating, and requiring care from a main carer in their family. The data was collected through interviews, observation, existing documentation and field notes. Qualitative analysis techniques were used to codify and classify the data and to formulate significant categories, which generated typologies of care. RESULTS AND DISCUSSION: The central idea was the Transition of Care and showed the context in three typologies: The care process for the dependent elderly person, Strategies for the care process and Impact and acceptance of the limitations. CONCLUSION: The data indicates that caring for an elderly person after a cerebrovascular accident is a challenge for the family. The data permitted it possible to elaborate a proposal for a model for the organization of the work, with a view to holistic care delivery in the health services, forming a care network, which constitutes an advance for the area of nursing.OBJETIVO: examinar la transición del cuidado en familias que cuidan de adultos mayores que sufrieron el primer episodio de accidente cerebral vascular. METODOLOGÍA: Fue utilizado el estudio de caso etnográfico instrumental. La muestra fue constituida de 20 sujetos, siendo 10 cuidadores y 10 adultos con 65 años y más, de ambos sexos, con diagnóstico de primer episodio de accidente cerebral vascular, capaces de comunicarse, demandando cuidado de un cuidador principal en la familia. Los datos fueron colectados por medio de entrevistas, observaciones, documentos existentes y notas de campo. Fueron utilizadas las técnicas de análisis cualitativo para

Clinical significance of determination of plasma NPY levels and serum lipid profile in patients with cerebral hemorrhage and cerebral infarction

International Nuclear Information System (INIS)

Huang Fujuan; Shen Airong; Yang Yongqing

2010-01-01

Objective: To study the clinical significance of changes of plasma NPY levels and serum lipid profile in patients with cerebral hemorrhage and cerebral infarction. Methods: Plasma NPY levels (with RIA) and serum lipid profile (with biochemistry) were determined in (1) 48 patients with acute cerebral hemorrhage (2) 46 patients with acute cerebral infarction and (3) controls.Results Plasma NPY levels in both patients with cerebral hemorrhage and patients with cerebral infarction were significantly higher than those in controls (P 0.05). Conclusion: NPY played important roles in the development and pathogenesis of cerebral vascular accidents. Lipid profile changes was the basic etiological factor. (authors)

Cerebral energy metabolism in streptozotocin-diabetic rats

NARCIS (Netherlands)

Biessels, G.J.; Braun, K.P.J.; Graaf, de R.A.; Eijsden, van P.; Gispen, W.H.; Nicolaij, K.

2001-01-01

Aims/hypothesis. It is increasingly evident that the brain is another site of diabetic end-organ damage. The pathogenesis has not been fully explained, but seems to involve an interplay between aberrant glucose metabolism and vascular changes. Vascular changes, such as deficits in cerebral blood

Enfermedad trofoblástica gestacional

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Ariel Labrada Salas

2014-09-01

Full Text Available Se presenta un caso con enfermedad trofoblástica gestacional de diagnóstico tardío, que debutó con manifestaciones respiratorias, producidas por metástasis pulmonares. Los datos se obtuvieron de la historia clínica de la paciente y, además, se revisó la literatura. Se trata de una paciente de 23 años de edad, con antecedentes de dos abortos espontáneos recientes, que ingresó por manifestaciones clínicas y radiológicas sugestivas de neumonía de la comunidad, con derrame pleural paraneumónico, siendo tratada con antibióticos de amplio espectro sin respuesta adecuada. Después del ingreso apareció dolor en hipogastrio y se le realizó un ultrasonograma ginecológico, que mostró quistes de ovario bilaterales, y una laparoscopía que informó quiste de ovario con compromiso vascular, por lo que se le practicó histerectomía total. Se determinaron niveles elevados de gonadotropina coriónica humana en sangre. En la tomografía axial computarizada de pulmón se observaron imágenes nodulares en ambos campos pulmonares, de aspecto metastásico. El estudio citológico del líquido pleural fue positivo de células neoplásicas. Se planteó el diagnostico de enfermedad trofoblástica con metástasis pulmonares y se inició quimioterapia con metotrexato, con respuesta favorable

Correlation of angiography and MR imaging in cerebral vasculitis

International Nuclear Information System (INIS)

Cloft, H.J.; Phillips, C.D.; Dix, J.E.; McNulty, B.C.; Kallmes, D.F.; Zagardo, M.T.

1999-01-01

Purpose: MR imaging and cerebral angiography were correlated in patients with primary angiitis of the central nervous system (PACNS) to assess the relative roles of these imaging modalities in the diagnosis. Material and Methods: In 9 patients, MR imaging and angiography were compared with regard to the relative involvement of each major vascular territory. Vascular territories assessed were the anterior, middle, and posterior cerebral arteries, and the posterior fossa. Results: All patients had angiographic findings consistent with vasculitis in multiple vascular territories. MR findings ranged from normal to diffusely abnormal. One patient had a completely normal MR investigation. Of 50 territories affected by vasculitis on angiography, 17 (34%) were normal on MR. Conclusion: Relative to cerebral angiography, MR imaging is a poor indicator of the presence or absence of PACNS. Angiography is indicated when clinical suspicion of PACNS is strong, regardless of the findings on MR. (orig.)

Enfermedades de notificación obligatoria

OpenAIRE

Instituto Nacional de Salud

2008-01-01

Presenta datos estadísticos de Enfermedades inmunoprevenibles como: Rubéola y sarampión, Tos ferina, Influenza A H1N1; Enfermedades transmitidas por vectores como: Dengue, Fiebre amarilla, Enfermedad de Carrión, Leismaniosis; Enfermedades zoonóticas como: Rabia anima y por último enfermedades de Transmisión sexual como: VIH - SIDA

Enfermedades de notificación obligatoria

OpenAIRE

Instituto Nacional de Salud

2009-01-01

Presenta datos estadísticos de Enfermedades inmunoprevenibles como: Rubéola y sarampión, Tos ferina, Influenza A H1N1; Enfermedades transmitidas por vectores como: Dengue, Fiebre amarilla, Enfermedad de Carrión, Leismaniosis; Enfermedades zoonóticas como: Rabia animal y por último enfermedades de Transmisión sexual como: VIH - SIDA

Enfermedades de notificación obligatoria

OpenAIRE

Instituto Nacional de Salud

2008-01-01

Presenta datos estadísticos de Enfermedades inmunoprevenibles como: Rubéola y sarampión, Tos ferina, Influenza A H1N1; Enfermedades transmitidas por vectores como: Dengue, Fiebre amarilla, Enfermedad de Carrión, Leismaniosis; Enfermedades zoonóticas como: Rabia animal y por último enfermedades de Transmisión sexual como: VIH - SIDA

MRI of sickle cell cerebral infarction

International Nuclear Information System (INIS)

Zimmerman, R.A.; Goldberg, H.I.; Bilaniuk, L.T.; Hackney, D.B.; Johnson, M.; Grossman, R.I.; Hecht-Leavitt, C.; Gill, F.; Pennsylvania Univ., Philadelphia

1987-01-01

Eleven patients with sickle cell disease and neurological symptoms underwent MRI examination. Cerebral infarcts of two types were found, those in the vascular distribution of the middle cerebral artery and those in the deep white matter. In the patient whose hydration and whose oxygenation of erythrocytes has been treated, MRI offers diagnostic advantages over arteriography and CT. (orig.)

Vascular Variations Associated with Intracranial Aneurysms.

Science.gov (United States)

Orakdogen, Metin; Emon, Selin Tural; Somay, Hakan; Engin, Taner; Is, Merih; Hakan, Tayfun

2017-01-01

To investigate the vascular variations in patients with intracranial aneurysm in circle of Willis. We used the data on 128 consecutive intracranial aneurysm cases. Cerebral angiography images were analyzed retrospectively. Arteries were grouped as anterior cerebral arterial system (ACS), posterior cerebral arterial system (PCS) and middle cerebral arterial system (MCS) for grouping vascular variations. Lateralization, being single/multiple, gender; and also any connection with accompanying aneurysms" number, localization, dimension, whether bleeding/incidental aneurysm has been inspected. Variations were demonstrated in 57.8% of the cases. The most common variation was A1 variation (34.4%). The rate of variations was 36.7%, 24.2% and 10.2% respectively in ACS, PCS and MCS. MCS variations were significantly higher in males. Anterior communicating artery (ACoA) aneurysm observance rates were significantly higher and posterior communicating artery (PCoA) aneurysm and middle cerebral artery (MCA) aneurysm observance rates were significantly lower when compared to "no ACS variation detected" cases. In "PCS variation detected" cases, PCoA aneurysm observance rates and coexistence of multiple variations were significantly higher. The rate of vascular variations in patients with aneurysms was 57.8%. Arterial hypoplasia and aplasia were the most common variations. ACS was the most common region that variations were located in; they were mostly detected on the right side. Coexistence of ACoA aneurysm was higher than PCoA and MCA aneurysms. In the PCS variations group, PCoA aneurysms were the most common aneurysms that accompanying the variation and multiple variations were more common than in the other two groups. The variations in MCS were most common in males.

Enfermedades de notificación obligatoria

OpenAIRE

Instituto Nacional de Salud

2005-01-01

Presenta enfermedades inmunoprevenibles como: Sarampión y rubéola, Tos Ferina; Enfermedades trnasmitidas por vectores: dengue, Fiebre amarilla, Leismaniosis; Enfermedades de transmisión sexual: VIH/SIDA; Enfermedades zoonóticas: rabia animal

Spinal vascular malformations in non-perimesencephalic subarachnoid hemorrhage

NARCIS (Netherlands)

Germans, M. R.; Pennings, F. A.; Sprengers, M. E. S.; Vandertop, W. P.

2008-01-01

OBJECTIVE: In patients with non-traumatic subarachnoid hemorrhage (SAH) and no evidence for a cerebral aneurysm on angiography, a frequent cause of the hemorrhage is perimesencephalic hemorrhage or other cerebral vascular pathology. In some patients no cause is found. The exact incidence of a spinal

Enfermedades de notificación obligatoria

OpenAIRE

Instituto Nacional de Salud

2009-01-01

Artículo online Presenta datos estadísticos de Enfermedades inmunoprevenibles como: Rubéola y sarampión, Tos ferina, Influenza A H1N1; Enfermedades transmitidas por vectores como: Dengue, Fiebre amarilla, Enfermedad de Carrión, Leismaniosis; Enfermedades zoonóticas como: Rabia animal y por último enfermedades de Transmisión sexual como: VIH - SIDA

Enfermedades de notificación obligatoria

OpenAIRE

Instituto Nacional de Salud

2011-01-01

Presenta datos estadísticos de las enfermedades inmunoprevenibles como: Rubéola y sarampión, Tos ferina, Influenza A H1N1; enfermedades transmitidas por vectores como: Dengue, Fiebre amarilla, Enfermedad de Carrión, Leismaniosis; enfermedades zoonóticas como: Rabia animal y Rabia humana y por último enfermedades de Transmisión sexual como: VIH - SIDA

Enfermedades de notificación obligatoria

OpenAIRE

Instituto Nacional de Salud

2010-01-01

Artículo online Presenta datos estadísticos de Enfermedades inmunoprevenibles como: Rubéola y sarampión, Tos ferina, Influenza A H1N1; Enfermedades transmitidas por vectores como: Dengue, Fiebre amarilla, Enfermedad de Carrión, Leismaniosis; Enfermedades zoonóticas como: Rabia animal y Rabia humana y por último enfermedades de Transmisión sexual como: VIH - SIDA

NEUROIMÁGENES EN ENFERMEDAD DE PARKINSON: ROL DE LA RESONANCIA MAGNÉTICA, EL SPECT Y EL PET

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Dr. Carlos Juri C.

2016-05-01

Full Text Available La enfermedad de Parkinson (EP es un trastorno neurodegenerativo, caracterizado por la pérdida progresiva de neuronas monoaminérgicas, en especial dopaminérgicas. En las últimas décadas, se han desarrollado diversos biomarcadores para el estudio de los pacientes con EP. Un grupo de estos biomarcadores son las neuroimágenes, como la resonancia magnética cerebral y las imágenes moleculares, en particular, la tomografía por emisión de positrones (PET y la tomografía por emisión de fotón único (SPECT. Estas técnicas, se han empleado en el diagnóstico temprano de la EP, así como para mejorar el diagnóstico diferencial entre EP y otros parkinsonismos y para monitorizar la progresión de la enfermedad. Con estos fines, se ha utilizado la capacidad de estas técnicas para evaluar la pérdida de la actividad dopaminérgica y de otras vías monoaminérgicas, al igual que la posibilidad de valorar la inflamación y el metabolismo a nivel cerebral. Recientemente, los nuevos criterios para el diagnóstico de la EP reconocen al PET y SPECT como herramientas valiosas en el diagnóstico de esta enfermedad. En este artículo, se analiza la utilidad actual de las técnicas de imagen en pacientes con EP y otros parkinsonismos y sus potenciales aplicaciones futuras.

A compreensão do significado cultural do aneurisma cerebral e do tratamento atribuídos pelo paciente e familiares: um estudo etnográfico La comprensión del significado cultural del aneurisma cerebral y del tratamiento atribuídos por el paciente y los familiares: un estudio etnográfico The cultural meaning of cerebral aneurysm and its treatment for the patient and relatives: an ethnographic study

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Maria Helena Pinto

2000-01-01

Full Text Available Este trabalho consiste de um estudo etnográfico descritivo, com 13 pacientes acometidos pelo aneurisma cerebral e seus familiares, com o objetivo de compreender o significado da doença e do tratamento. Os dados foram coletados por entrevistas e observações durante a hospitalização e depois da alta, no ambulatório e na residência. O tema central obtido do estudo foi "Tinha que ser para mim. Deus sabe o que faz". Este tema revela uma interpretação religiosa para a doença e uma fundamentação mágica para o tratamento. Assim, o aneurisma cerebral é interpretado como uma doença material (corpo e uma doença espiritual (alma.Esta investigación consiste en un estudio etnográfico de los pacientes afectados por aneurisma cerebral y sus familiares, con el objetivo de objetivo de comprender el significado de la enfermedad y el tratamiento. Los datos fueron recolectados por entrevistas y observaciones durante la hospitalización y después del alta en la consulta externa y en la residencia. El tema central obtenido del estudio fue: "Tenia que ser para mi. Dios sabe lo que hace". Este tema manifiesta una interpretación religiosa para la enfermedad y una fundamentación mágica para el tratamiento. Así, el aneurisma cerebral es comprendido como una enfermedad material (del cuerpo y una enfermedad espiritual (del alma.This is a descriptive ethnographic study with 13 patients with cerebral aneurysm and their relatives aiming at understanding the meaning of the illness and the treatment. The data were collected by interviews and observations during the hospitalization and, after the discharge, in the outpatient clinic and at home. The central theme obtained from the study was "It had to be for me! God knows what He does". This theme reveals a religious interpretation for the illness and a magic basis for its cure.Thus, cerebral aneurysm is interpreted as a material illness (body and a spiritual illness (soul.

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

International Nuclear Information System (INIS)

Saito, Yuko

1982-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

1982-09-01

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

Mechanical injury induces brain endothelial-derived microvesicle release: Implications for cerebral vascular injury during traumatic brain injury

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Allison M. Andrews

2016-02-01

occludin following brain trauma. These results indicate that following TBI, the cerebral endothelium undergoes vascular remodeling through shedding of eMVs containing TJPs and endothelial markers. The detection of this shedding potentially allows for a novel methodology for real-time monitoring of cerebral vascular health (remodeling, BBB status and neuroinflammation following a TBI event.

Mechanical Injury Induces Brain Endothelial-Derived Microvesicle Release: Implications for Cerebral Vascular Injury during Traumatic Brain Injury.

Science.gov (United States)

Andrews, Allison M; Lutton, Evan M; Merkel, Steven F; Razmpour, Roshanak; Ramirez, Servio H

2016-01-01

. These results indicate that following TBI, the cerebral endothelium undergoes vascular remodeling through shedding of eMVs containing TJPs and endothelial markers. The detection of this shedding potentially allows for a novel methodology for real-time monitoring of cerebral vascular health (remodeling), BBB status and neuroinflammation following a TBI event.

Demencia en la enfermedad de Alzheimer: un enfoque integral Dementia in Alzheimer's disease: a comprehensive approach

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Víctor T. Pérez Martínez

2005-08-01

Full Text Available El substrato patológico de la principal de las demencias, lo constituyen las siguientes lesiones: la degeneración neurofibrilar abundante y difusa, las placas neuríticas y el depósito anormal de sustancia amiloide en el cerebro, causante de la toxicidad cerebral. La demencia en la enfermedad de Alzheimer cumple con un patrón clínico-topográfico de tipo cortical característico. Su diagnóstico definitivo es anatomopatológico, pero se puede establecer un diagnóstico probable basado en la clínica y en la evaluación neuropsicológica. No existe tratamiento efectivo concluyente para el deterioro cognitivo de la enfermedad de Alzheimer.The pathological substrate of the main dementia is composed of the following lesions: the diffuse and abundant neurofibrillar degeneration, the neuritic plaques and the abnormal deposit of amyloid substance in the brain, causing cerebral toxicity. Dementia in Alzheimer's disease accomplishes a clinicotopographic pattern of characteristic cortical type. Its definitive diagnosis is anatomopathological, but a probable diagnosis based on the clinic and the neuropsychological evaluation can be established. There is no a concluding effective treatment for the cognitive deterioration of Alzheimer's disease.

Enfermedad de Kawasaki

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Carlos Coronel Carvajal

2003-09-01

Full Text Available Se realizó una revisión actualizada de la enfermedad de Kawasaki, con el objetivo de familiarizar a pediatras y médicos de la familia con los elementos clínicos de la enfermedad, para que de esta manera pueda ser diagnosticada y manejada oportunamente. La enfermedad de Kawasaki fue descrita por Tomisaki Kawasaki en 1967, y se manifiesta como un síndrome febril en la niñez temprana. La enfermedad se diagnostica con mayor frecuencia en los menores de 5 años, a través de una serie de criterios clínicos establecidos. La forma típica de la enfermedad tiene 3 fases de duración variable. La afectación cardíaca es la manifestación más importante de la enfermedad, del 10 al 40 % de los niños muestran signos de vasculitis coronaria, manifestada por aneurismas de las arterias coronarias.An updated review of Kawasaki disease was carried out to make pediatricians and family physicians familiar with the clinical elements of the disease so that it can be properly diagnosed and managed. Kawasaki disease was described by Tomisaki Kawasaki in 1967 and manifests as a febrile syndrome at early childhood. The disease is very often diagnosed in under five years-old children on the basis of a series of set clinical criteria. The typical form of the disease had 3 phases of variable duration. The cardiac effect is the most important manifestation of the disease since 10 to 40 % of children show signs of coronary vasculitis in the form of coronary arterial aneurysms.

Proposal for a universal definition of cerebral infarction.

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Saver, Jeffrey L

2008-11-01

Cerebral infarction is a leading cause of disability and death worldwide but has no uniform international definition. Recent diagnostic advances have revised fundamental concepts in cerebral and cardiac ischemia. Cardiologists, already possessed of a nosologic framework distinguishing myocardial infarction from unstable angina on the basis of tissue state, promulgated a new "universal" tissue definition of myocardial infarction incorporating insights afforded by assays of cardiac troponin, a serum biomarker exquisitely sensitive to myocardial injury. Concurrently, vascular neurologists proposed a new tissue, rather than time, criterion to distinguish transient ischemia attack from cerebral infarction, responding to perspectives provided by diffusion MRI and cerebral blood volume CT, imaging biomarkers highly sensitive to neuronal injury. To complete this conceptual realignment, vascular neurology must now advance a clear, uniform, and operationalizable tissue definition of cerebral infarction. This review proposes cerebral infarction be defined as brain or retinal cell death due to prolonged ischemia. This definition categorizes both pannecrosis and neuronal dropout ("complete" and "incomplete" infarcts in classic neuropathologic terminology) as cerebral infarcts. Making the presence of any neuronal or glial cell death essential yields a definition of cerebral infarction that has high relevance to patients, physicians, and policymakers; is more easily applied in clinical practice; fosters action in acute care; harmonizes with myocardial ischemia classification; and focuses diagnostic evaluation on the cause of brain ischemia and the occurrence of end organ injury. The term cerebral infarction should be used when there is evidence of brain or retinal cell death due to cerebral ischemia.

Relation of plasma homocyst(e)ine to cerebral infarction and cerebral atherosclerosis.

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Yoo, J H; Chung, C S; Kang, S S

1998-12-01

A number of investigations support the theory that the elevated plasma homocyst(e)ine is associated with occlusive vascular disease. The aim of this study is to examine whether moderate hyperhomocyst(e)inemia is an independent risk factor for cerebral infarction. In addition, we examined the association between plasma homocyst(e)ine and the severity of cerebral atherosclerosis. We conducted a hospital-based case-control study with 140 male controls and 78 male patients with nonfatal cerebral infarction, aged between 39 and 82 years. Plasma homocyst(e)ine levels were analyzed in 218 subjects. Fifty-five patients were evaluated for cerebral vascular stenosis by MR angiography. The mean plasma level of homocyst(e)ine was higher in cases than in controls (11.8+/-5.6 versus 9.6+/-4.1 micromol/L; P=0.002). The proportion of subjects with moderate hyperhomocyst(e)inemia was significantly higher in cases than in controls (16.7% versus 5.0%; P=0.004). Based on the logistic regression model, the odds ratio of the highest 5% of homocyst(e)ine levels in control group was 4.17 (95% confidence interval, 3.71 to 4. 71)(P=0.0001). After additional adjustment for total cholesterol, hypertension, smoking, diabetes, and age, the odds ratio was 1.70 (95% confidence interval, 1.48 to 1.95) (P=0.0001). The plasma homocyst(e)ine levels of patients having vessels with 3 or 2 stenosed sites were significantly higher than those of patients having vessels with 1 stenosed site or normal vessels (14.6+/-1.4, 11.0+/-1.4 versus 7.8+/-1.5, 8.9+/-1.4 micromol/L respectively; P<0. 02). Multiple logistic regression analysis revealed that moderate hyperhomocyst(e)ienemia was significantly associated with the number of stenosed vessels (P=0.001). These findings suggest that moderate hyperhomocyst(e)inemia is an independent risk factor for cerebral infarction and may predict the severity of cerebral atherosclerosis in patients with cerebral infarction.

[Cerebral hemodynamics in patients with neurosensory hearing loss before and after magnetotherapy].

Science.gov (United States)

Morenko, V M; Enin, I P

2001-01-01

Magnetotherapy effects on cerebral hemodynamics were studied using rheoencephalography (REG). When the treatment results and changes in cerebral hemodynamics were compared it was evident that normalization or improvement of vascular status in vertebrobasilar and carotid territories registered at REG results in better hearing. This confirms the role of vascular factor in pathogenesis of neurosensory hypoacusis of different etiology and effectiveness of magnetotherapy in such patients.

Relationship between cerebral blood flow and later cognitive decline in hypertensive patients with cerebral small vessel disease

International Nuclear Information System (INIS)

Kitagawa, Kazuo; Oku, Naohiko; Yagita, Yoshiki; Sakaguchi, Manabu; Sakoda, Saburo; Kimura, Yasuyuku; Hatazawa, Jun

2009-01-01

Vascular risk factors are thought to be important for dementia. However, there is little evidence for a prospective association between cerebral blood flow and the risk of cognitive decline. Twenty-seven cognitively intact hypertensive patients aged 55 years and older with lacunar infarction or white matter lesions in magnetic resonance imaging (MRI) underwent positron emission tomography (PET) to measure cerebral blood flow (CBF) and cerebral vascular reactivity (CVR). Cognitive function was assessed at baseline and 3 years later with the mini-mental state examination (MMSE). Patients whose MMSE score fell by more than three points were classified as having cognitive decline. Six patients showed cognitive decline. Baseline CBF in these patients was significantly lower than that of the 21 patients without cognitive decline (31.2±2.4 vs. 42.6±5.9 ml per 100 gmin -1 , respectively; P<0.001). A moderate linear association was found between CBF and change in MMSE score over a 3-year period (r=0.59, P=0.001), not between CBF and baseline MMSE score. In contrast, no association between CVR and later cognitive decline was found. This study suggests that cerebral hypoperfusion is associated with later cognitive decline. (author)

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

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Tania Fernandes Campos

2007-01-01

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

Paradoxical embolisation and cerebral white matter lesions in dementia.

NARCIS (Netherlands)

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

2008-01-01

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

DIAGNÓSTICO CLÍNICO Y MANEJO DE LA TROMBOSIS VENOSA CEREBRAL. PRESENTACIÓN DE UN CASO CLÍNICO.

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Yorman Rafael Flores Molina

2011-01-01

Full Text Available La Trombosis de los Senos Durales y/o Trombosis Venosa Cerebral, se considera una entidad poco frecuente de accidente cerebro vascular que usualmente ocurre en individuos jóvenes. Cada año, afecta a 5 personas por millón a nivel mundial y representa el 0.5 al 1% de todos los episodios de enfermedad cerebrovascular. Se describe el caso de un paciente masculino de 31 años, sin antecedentes patológicos conocidos, que consultó en el servicio de urgencias por cefalea holocraneana y movimientos tónico-clónicos generalizados; se le practicó Tomografía Axial Computarizada Cerebral y Arteriografía de 4 vasos, descartándose malformaciones arteriovenosas y/o aneurismas cerebrales. Se solicita Angioresonancia, que revela Imágenes de defecto sugestivas a Trombosis del Seno Longitudinal Superior, por lo que se indica anticoagulación con Heparina de Bajo Peso Molecular y Warfarina Sódica, obteniéndose una evolución favorable. A propósito de este caso, se realiza una revisión de la literatura, haciendo especial énfasis en su diagnóstico, factores de riesgo y controversias terapéuticas.

Prevalência de disfagia orofaríngea no acidente vascular cerebral após cirurgia cardíaca

OpenAIRE

Tatiana Magalhães de Almeida; Paula Cristina Cola; Daniel Magnoni; João Ítalo Dias França; Roberta Gonçalves da Silva

2015-01-01

Resumo: OBJETIVO: determinar a prevalência de disfagia orofaríngea em indivíduos submetidos à cirurgia cardíaca e que evoluíram com Acidente Vascular Cerebral em Hospital Público de Referência. MÉTODOS: estudo clínico descritivo, retrospectivo, realizado por meio da coleta de dados de protocolos de avaliação clínica da deglutição orofaríngea, no período de novembro de 2010 á novembro de 2011. Foram incluídos os 25 protocolos de avaliação clínica para disfagia orofaríngea de indivíduos que f...

Síndrome coronario agudo y enfermedad de Erdheim-Chester. Patogénesis e implicaciones terapéuticas

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José Carlos Alarcón-García

2017-05-01

Full Text Available La enfermedad de Erdheim-Chester es una histiocitosis celular diferente a la histiocitosis de Langerhans, de origen incierto. Se caracteriza por una implicación multi-orgánica debida a la infiltración de los histiocitos CD68+/CD1a-, en forma de xantogranulomas, que afectan principal y comúnmente a la metáfisis y diáfisis de huesos largos. El diagnóstico se realiza mediante biopsia, donde se revelan histiocitos CD68+/CD1a-, carencia de proteína S, y presencia de gránulos de Birbeck. Se ha subestimado la implicación cardiovascular. Reportamos un caso de un varón de 67 años con la enfermedad de Erdheim-Chester e infarto de miocardio agudo, debido a implicación coronaria, además de enfermedad ósea, vascular, pituitaria y retroperitoneal. Revisamos la literatura relevante y describimos el tratamiento clínico de estos pacientes.

Enfermedades fungosas y bacteriales del clavel en Colombia

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Arbelaez Torres Germán

1987-12-01

Full Text Available Carnation is the most important ornamental grown in colombian greenhouses. Among the fungal diseases, one of the pathogen with great importance is Fusaríum oxysporum f. sp, dianthi. The vascular wilt pathogen Phíalophora cinerescens is also found but with a very narrow distribution.
Stem rot caused by Fusaríum roseum is found is greenhouses with poor management and mainly after harvesting. Other soil
pathogens as Rhízoctonía sotsni, Sclerotínia scterotiorum, Phythium sp, and Phytophthora sp. ha ve been ocasionally recognized. Among diseases than affect the foliage, the most important pathogen is Heterosporium echinulatum particularly in miniature carnation and in some mediterranean standard varieties. Carnation rust caused by Uromyces caryophyllinus causes important losses in some areas at the Bogotá plateau,
specially during the rainy season. Leaf spot caused by Alternaría dianthi has a very little importance and it is present at cutting rooting periodo Peronospora diathicola is also
found with low incidence. Flower rooting produced by Botrytis cinerea has been reported with a mild incidence particularly
during rainy season on some varieties. The importance of this pathogen on carnation is minor comparad to its importance on other ornamental crops, such as statice and chrysanthemum.
Among bacterial diseases only the leaf spot caused by Pseudomonss woodsii has been recorded with a very low incidence.
El clavel es el cultivo más importante dentro de las flores de exportación cultivadas en Colombia. Dicho cultivo es afectado por un número importante de enfermedades fungosas. La enfermedad más importante y de mayor distribución en Colombia es la ocasionada por Fusaríum oxysporum f. so, dianthi, en forma similar a como ocurre en la mayoría de los países productores de clavel en el mundo. La enfermedad vascular ocasionada por Phíalophora cinerescens se presenta también pero con una distribuci

13-Methyltetradecanoic acid mitigates cerebral ischemia/reperfusion injury

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Juan Yu

2016-01-01

Full Text Available 13-Methyltetradecanoic acid can stabilize cell membrane and have anti-inflammatory, antioxidant and anti-apoptotic effects. Previous studies mainly focused on peripheral nerve injury, but seldom on the central nervous system. We investigated whether these properties of 13-methyltetradecanoic acid have a neuroprotective effect on focal cerebral ischemia/reperfusion injury, and detected the expression of basic fibroblast growth factor and vascular endothelial growth factor. This study established rat models of middle cerebral artery occlusion/reperfusion injury by ischemia for 2 hours and reperfusion for 24 hours. At the beginning of reperfusion, 13-methyltetradecanoic acid 10, 40 or 80 mg/kg was injected into the tail vein. Results found that various doses of 13-methyltetradecanoic acid effectively reduced infarct volume, mitigate cerebral edema, and increased the mRNA and protein expression of basic fibroblast growth factor and vascular endothelial growth factor at 24 hours of reperfusion. The effect was most significant in the 13-methyltetradecanoic acid 40 and 80 mg/kg groups. The findings suggest that 13-methyltetradecanoic acid can relieve focal ischemia/reperfusion injury immediately after reperfusion, stimulate the upregulation of basic fibroblast growth factor and vascular endothelial growth factor to exert neuroprotective effects.

Morning Glory Syndrome with Carotid and Middle Cerebral Artery Vasculopathy.

Science.gov (United States)

Nezzar, Hachemi; Mbekeani, Joyce N; Dalens, Helen

2015-12-01

To report a case of incidental asymptomatic atypical morning glory syndrome (MGS) with concomitant ipsilateral carotid and middle cerebral dysgenesis. A 6-year-old child was discovered to have incidental findings of MGS, with atypia. All visual functions were normal including vision and stereopsis. Neuroimaging revealed ipsilateral carotid and middle cerebral vascular narrowing without associated collateral vessels or cerebral ischemia commonly seen in Moyamoya disease. Subsequent annual examinations have been stable, without signs of progression. This case demonstrates disparity between structural aberrations and final visual and neurological function and reinforces the association between MGS and intracranial vascular disruption. Full ancillary ophthalmic and neuroimaging studies should be performed in all patients with MGS with interval reassessments, even when the patient is asymptomatic and functionally intact.

Hyperacute unilateral contrast-induced parotiditis during cerebral angiography

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Song J. Kim, MD

2018-02-01

Full Text Available An uncommon complication of iodinated contrast administration is the development of bilateral sialadenitis. We report a unique case of hyperacute unilateral parotiditis during diagnostic cerebral angiography of the external carotid artery, which mimicked possible iatrogenic vascular event associated with cerebral endovascular procedures. Discussion includes the differential diagnosis, diagnostic studies, and treatments for this unusual condition.

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

Science.gov (United States)

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

2012-02-01

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

Cerebral ischemia produced by four-vessel occlusion in the rat: a quantitative evaluation of cerebral blood flow

International Nuclear Information System (INIS)

Furlow, T.W. Jr.

1982-01-01

Cerebral ischemia was produced in the rat by simultaneous occlusion of the vertebral and carotid arteries according to the method of Pulsinelli and Brierley (Stroke 10: 267, 1979). Local cerebral blood flow (CBF) was determined by polarographic and autoradiographic techniques. Hydrogen-clearance measurements showed that mean CBF fell in four monitored regions of the hemispheres to between 0.11 and 0.18 ml/g/min, being least in deep rostal gray, intermediate in superficial gray, and greatest in deep caudal gray. However, individual animals had local CBF in excess of 0.20 and even 0.30 ml/g/min, and no animal showed zero CBF. When animals were rendered hypotensive (MABP of 50 Torr) during vascular occlusion, mean CBF ranged between 0.03 and 0.10 ml/g/min in the same regional order. With hypotension, total arrest of flow occurred. Autoradiographic data confirmed the above findings and indicated adequate CBF to the lower brainstem. During vascular occlusion, sufficient CBF may be present ot sustain cerebral tissue as in animals with a well developed spinal circulation or an inadvertently patent vertebral artery

Axon-glial disruption: the link between vascular disease and Alzheimer's disease?

Science.gov (United States)

Horsburgh, Karen; Reimer, Michell M; Holland, Philip; Chen, Guiquan; Scullion, Gillian; Fowler, Jill H

2011-08-01

Vascular risk factors play a critical role in the development of cognitive decline and AD (Alzheimer's disease), during aging, and often result in chronic cerebral hypoperfusion. The neurobiological link between hypoperfusion and cognitive decline is not yet defined, but is proposed to involve damage to the brain's white matter. In a newly developed mouse model, hypoperfusion, in isolation, produces a slowly developing and diffuse damage to myelinated axons, which is widespread in the brain, and is associated with a selective impairment in working memory. Cerebral hypoperfusion, an early event in AD, has also been shown to be associated with white matter damage and notably an accumulation of amyloid. The present review highlights some of the published data linking white matter disruption to aging and AD as a result of vascular dysfunction. A model is proposed by which chronic cerebral hypoperfusion, as a result of vascular factors, results in both the generation and accumulation of amyloid and injury to white matter integrity, resulting in cognitive impairment. The generation of amyloid and accumulation in the vasculature may act to perpetuate further vascular dysfunction and accelerate white matter pathology, and as a consequence grey matter pathology and cognitive decline.

Protective or pathogenic effects of vascular endothelial growth factor (VEGF) as potential biomarker in cerebral malaria.

Science.gov (United States)

Canavese, Miriam; Spaccapelo, Roberta

2014-03-01

Cerebral malaria (CM) is the major lethal complication of Plasmodium falciparum infection. It is characterized by persistent coma along with symmetrical motor signs. Several clinical, histopathological, and laboratory studies have suggested that cytoadherence of parasitized erythrocytes, neural injury by malarial toxin, and excessive inflammatory cytokine production are possible pathogenic mechanisms. Although the detailed pathophysiology of CM remains unsolved, it is thought that the binding of parasitized erythrocytes to the cerebral endothelia of microvessels, leading to their occlusion and the consequent angiogenic dysregulation play a key role in the disease pathogenesis. Recent evidences showed that vascular endothelial growth factor (VEGF) and its receptor-related molecules are over-expressed in the brain tissues of CM patients, as well as increased levels of VEGF are detectable in biologic samples from malaria patients. Whether the modulation of VEGF is causative agent of CM mortality or a specific phenotype of patients with susceptibility to fatal CM needs further evaluation. Currently, there is no biological test available to confirm the diagnosis of CM and its complications. It is hoped that development of biomarkers to identify patients and potential risk for adverse outcomes would greatly enhance better intervention and clinical management to improve the outcomes. We review and discuss here what it is currently known in regard to the role of VEGF in CM as well as VEGF as a potential biomarker.

Clinical application of three-dimensional spiral CT cerebral angiography with volume rendering

International Nuclear Information System (INIS)

Duan Shaoyin; Huang Xi'en; Kang Jianghe; Zhang Dantong; Lin Qingchi; Cai Guoxiang; Xu Meixin; Pang Ruilin

2002-01-01

Objective: To study the methodology and assess the clinical value of three-dimensional CT angiography (3D-CTA) with volume rendering (VR) in cerebral vessels. Methods: Sixty-two patients were examined by means of 3D-CTA with volume rendering. VR was used in the reconstruction of 3D images, and the demonstration of normal vessels and vascular lesions were particularly analyzed. At the same time, comparisons were made between the images of VR and SSD, MIP, and also between the diagnosis of VR-CTA and DSA or postoperative results. Results: In VR images, cerebral vessel routes and vessel cavities were showed clearly, while the relationship among vascular lesions, surrounding vessels, and neighboring structure was distinguished. 50 cases (80.6%) were found positive, 48 of which were correct and 2 were false-positive compared with DSA or postoperative results. The accurate rate of diagnosis was 96.0%. There was no obvious difference in showing the cerebral vessel among the images of VR, SSD and MIP (P > 0.25). Conclusion: Three-dimensional CT cerebral angiography with VR is a new noninvasive effective method. It can even partly replace the DSA. The 3D-images have the characteristics of showing the cerebral vascular cavity and overlapped vessels without cutting the skull

Non operative management of cerebral abscess

Science.gov (United States)

Batubara, C. A.

2018-03-01

Cerebral abscess is a focal intracerebral infection that begins as a localized area of cerebritis and develops into a collection of pus surrounded by a well-vascularized capsule. Patients typically present with varying combinations of aheadache, progressive neurologic deficits, seizures, and evidence of infection. Computed Tomography and Magnetic Resonance Imagingare the most important diagnostic tools in diagnosing cerebral abscess. The treatment of cerebral abscess has been a challenge. Small cerebralabscesses (managed by the use of intravenous mannitol (or hypertonic saline) and dexamethasone. Acute seizures should be terminated with the administration of intravenous benzodiazepines or by intravenous fosphenytoin. Anticonvulsants prophylaxis must be initiated immediately and continued at least one year due to high risk in the cerebral abscesses. Easier detection of underlying conditions, monitoring of the therapeutic progress, and recognition of complications have probably contributed to the improved prognosis.

Effects of edaravone combined with hyperbaric oxygen on cerebral vascular dynamics, oxidative stress products and inflammatory factors in patients with acute cerebral hemorrhage

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Xia Li

2017-10-01

therapy can effectively improve cerebral vascular dynamics, reduce oxidative stress and inflammatory response in patients with ACH, which is beneficial to the prognosis of patients.

Accidente cerebro-vascular en la enfermedad de Fabry: Algo más que una simple estenosis Stroke in Fabry disease: More than a simple stenosis

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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.

Endothelial Mineralocorticoid Receptor Mediates Parenchymal Arteriole and Posterior Cerebral Artery Remodeling During Angiotensin II-Induced Hypertension.

Science.gov (United States)

Diaz-Otero, Janice M; Fisher, Courtney; Downs, Kelsey; Moss, M Elizabeth; Jaffe, Iris Z; Jackson, William F; Dorrance, Anne M

2017-12-01

The brain is highly susceptible to injury caused by hypertension because the increased blood pressure causes artery remodeling that can limit cerebral perfusion. Mineralocorticoid receptor (MR) antagonism prevents hypertensive cerebral artery remodeling, but the vascular cell types involved have not been defined. In the periphery, the endothelial MR mediates hypertension-induced vascular injury, but cerebral and peripheral arteries are anatomically distinct; thus, these findings cannot be extrapolated to the brain. The parenchymal arterioles determine cerebrovascular resistance. Determining the effects of hypertension and MR signaling on these arterioles could lead to a better understanding of cerebral small vessel disease. We hypothesized that endothelial MR signaling mediates inward cerebral artery remodeling and reduced cerebral perfusion during angiotensin II (AngII) hypertension. The biomechanics of the parenchymal arterioles and posterior cerebral arteries were studied in male C57Bl/6 and endothelial cell-specific MR knockout mice and their appropriate controls using pressure myography. AngII increased plasma aldosterone and decreased cerebral perfusion in C57Bl/6 and MR-intact littermates. Endothelial cell MR deletion improved cerebral perfusion in AngII-treated mice. AngII hypertension resulted in inward hypotrophic remodeling; this was prevented by MR antagonism and endothelial MR deletion. Our studies suggest that endothelial cell MR mediates hypertensive remodeling in the cerebral microcirculation and large pial arteries. AngII-induced inward remodeling of cerebral arteries and arterioles was associated with a reduction in cerebral perfusion that could worsen the outcome of stroke or contribute to vascular dementia. © 2017 American Heart Association, Inc.

The analysis of cerebro-vascular circulation time using digital subtraction angiography (DSA)

International Nuclear Information System (INIS)

Han, D. G.; Kim, D. H.; Lee, H. K.; Kwon, K. H.; Kim, K. J.

1986-01-01

We analyzed the cerebral arterio-venous circulation time of 141 cases of cranial DSA in 136 patients, for the assessment of cerebral circulatory dynamics. IV-DSA was 111 cases, IA-DSA 30 cases. The results were as follows: 1. There was no significant difference in arterio-venous circulation time between IA-DSA and IV-DSA, if the disease pattern was not considered (P > 0.1). 2. Prolongation of arterio-venous circulation time was noted in the cases of cerebral (cerebellar) hemorrhage, subarachnoid hemorrhage, intracranial hematoma, brain abscess, acute stage of cerebra-vascular occlusive disease, acute stage of postoperative follow up, and acute stage of cerebral contusion (p > 0.05). 3. Compared the chronic stage of cerebra-vascular occlusive disease, postoperative follow up, and cerebral contusion with acute stage, significant decrement of arterio-venous circulation time was resulted (p > 0.05). 4. DSA was a useful modality for the assessment of circulatory dynamics, including measurement of arterio-venous circulation time.

Ischemic Cardiomyopathy and Cerebral Infarction in a Young Patient Associated with Khat Chewing

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T. J. Meulman

2015-01-01

Full Text Available Khat is a stimulating agent used by many people in the Horn of Africa and the Arabian peninsula. Khat chewing is a known cardiovascular risk factor and is thought to cause vasoconstriction, systemic hypertension, and thrombogenicity. A 33-year-old Somalian man initially presented with loss of neurological function of the left arm, hazy vision, and headache. He smokes tobacco and chews two bundles of khat a week for more than 10 years. His ECG on admission showed a Q wave in V1 and V2 and 2 mm ST-elevations in V1, V2, and V3 and a terminal negative T wave in I, aVL, V2, V3, and V4, consistent with a recent, evolving anterior infarction. A noncontrast enhanced CT of the brain showed ischemia in the right middle cerebral artery vascular territory. An MRI showed recent ischemia in the vascular territory of the posterior division of the right middle cerebral artery. Coronary angiography showed a 70% stenosis with haziness of the proximal left anterior descending artery. Diagnostic tests and imaging are consistent with recent myocardial infarction in the LAD vascular territory because of coronary spasm and cerebral infarction in the middle cerebral artery vascular territory probably related to khat chewing.

TUBERCULOSIS COMO ENFERMEDAD OCUPACIONAL

Science.gov (United States)

Mendoza-Ticona, Alberto

2014-01-01

Existe evidencia suficiente para declarar a la tuberculosis como enfermedad ocupacional en diversos profesionales especialmente entre los trabajadores de salud. En el Perú están normados y reglamentados los derechos laborales inherentes a la tuberculosis como enfermedad ocupacional, como la cobertura por discapacidad temporal o permanente. Sin embargo, estos derechos aún no han sido suficientemente socializados. En este trabajo se presenta información sobre el riesgo de adquirir tuberculosis en el lugar de trabajo, se revisan las evidencias para declarar a la tuberculosis como enfermedad ocupacional en trabajadores de salud y se presenta la legislación peruana vigente al respecto. PMID:22858771

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

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Marcia Maiumi Fukujima

1996-06-01

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

Cerebral aneurysms – an audit | Louw | SA Journal of Radiology

African Journals Online (AJOL)

We performed an audit to determine the profile of cerebral aneurysms at the Universitas Hospital Bloemfontein, the only government hospital with a vascular suite in the Free State and Northern Cape area. Two hundred and twenty-three government patients, diagnosed with cerebral aneurysms during the period 1 January ...

Enfermedad de Niemann Pick tipo-A. Presentación de 12 casos

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Jorge Zarco-Román

2017-05-01

Full Text Available INTRODUCCIÓN: la enfermedad de Niemann Pick tipo A es una enfermedad hereditaria de depósito lisosomal, debida a un déficit de la enzima esfingomielinasa ácida, lo que da lugar a la acumulación de esfingomielina en las células del sistema reticuloendotelial y nervioso central. OBJETIVO: se describe el curso de la enfermedad de Niemann Pick tipo A en 12 pacientes: tres niños y nueve niñas, con edades entre 3 a 33 meses. MATERIAL Y MÉTODOS: estudio retrospectivo efectuado con base en la información de los expedientes de 12 pacientes, evaluados mediante un examen físico completo, oftalmológico, análisis de laboratorio, ultrasonido de abdomen, tomografía axial computarizada o resonancia magnética nuclear cerebral, radiografías de tórax, ecocardiograma, electroencefalograma, potenciales evocados auditivos y visuales, serie esofagogastroduodenal y serie ósea. Se obtuvo información sobre enfermedades intercurrentes y causas de muerte. RESULTADOS: la sintomatología comenzó en promedio a los 5.9 meses (2 a 16 meses y el diagnóstico definitivo se realizó a la edad de los 15.6 meses (3 a 33 meses a través del cuadro clínico sugestivo, con presencia de células espumosas en el aspirado de médula ósea 12/12 (100% y deficiencia de la enzima esfingomielinasa ácida en 12/12 pacientes (100%; la biopsia hepática fue sugestiva de enfermedad por atesoramiento en 5/12 (41.6%. Las manifestaciones clínicas por orden de frecuencia fueron: hepatoesplenomegalia y afección neurológica en 12/12 (100%, alteración pulmonar 11/12 (91.6%, hematológica 9/12 (80%, oftalmológica con mancha rojo cereza 9/12 (75%, ósea 6/12 (50%, y cardiaca 4/12 (33.3%. Únicamente hubo antecedente de consanguinidad en 4 familias (33.3%. CONCLUSIONES: el curso clínico de la enfermedad de Niemann Pick tipo A es muy similar entre los pacientes afectados, el primer dato clínico detectado es la hepatoesplenomegalia. Los pacientes están asintomáticos los primeros

CITICOLIN IN THE TREATMENT OF STROKE AND VASCULAR COGNITIVE DISORDERS

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Vladimir Anatol'evich Parfenov

2009-01-01

Full Text Available Citicolin (ceraxon is used as a neuroprotector in the treatment of acute stroke and vascular cognitive disorders. Experimental animal studies have demonstrated that citicolin reduces the extent of cerebral infarct and increases the degree of functional recovery. A few clinical trials have provided evidence for the efficacy of intravenous or oral citicolin used within the first 24 hours of ischemic stroke or cerebral hemorrhage in recovery of neurological functions. Citicolin is effective in memory and behavioral disorders in elderly patients with chronic cerebrovascular diseases. The use of citicolin has been found to be safe in stroke and vascular cognitive disorders

Factores de riesgo relacionados con mortalidad por enfermedad cerebro vascular. armenia 2008 = Risk factors associated with cerebrovascular disease mortality, Armenia, Colombia, 2008

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Álvarez Aristizábal, Luis Carlos

2011-03-01

Full Text Available Introducción: La Enfermedad cerebro vascular (ECV se encuentra entre las primeras causas de morbimortalidad en adultos en todo el mundo. Comparte con la enfermedad cardiovascular factores de riesgo modificables y no modificables; constituye una prioridad para la salud pública realizar todos los esfuerzos necesarios en la prevención primaria a través del tratamiento farmacológico y no farmacológico adecuados.Objetivo: Determinar la prevalencia y la mortalidad del accidente cerebrovascular y la relación con factores de riesgo.Métodos: se realizó un estudio de cross sectional .Se revisaron 318 historias clínicas de pacientes con diagnóstico de ECV que ingresaron a IPS de tercer nivel en la ciudad de Armenia entre 2005 y 2007. Se analizó la frecuencia de los factores de riesgo y se relacionaron con la mortalidad y tipos de ECV.Resultados: La edad promedio fue 72 años; la mortalidad del 29.9%. Presentaron ECV isquémico 61.9% y hemorrágica 38.1%, con una mortalidad de 21.3% y 43.8% respectivamente. Los factores de riesgo más prevalentes fueron: hipertensión arterial (74.5%, tabaquismo (23.3%, ACV o cardiopatía isquémica previos (15.4%, y diabetes (15.1%. Se encontraron asociados a mortalidad: presión arterial media al ingreso a urgencias mayor a 105 (OR 1.6, presión arterial diastólica mayor a 100 (OR 3.1 y ECV hemorrágica (OR 2.9.Conclusiones: los eventos hemorrágicos son menos frecuentes pero ocasionan mayor mortalidad que los isquémicos; es necesario realizar programas de prevención secundaria para el adecuado control de factores como la hipertensión arterial; además impulsar la promoción para el cambio a estilos de vida saludables.

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

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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.

Cerebral blood flow and cerebral oxygen metabolism in thalamic hemorrhage

International Nuclear Information System (INIS)

Yasui, Nobuyuki; Asakura, Ken

1987-01-01

Cerebral blood flow (CBF), cerebral oxygen consumption (CMRO 2 ), oxygen extraction fraction (OEF) and cerebral blood volume (CBV) were studied in 20 cases of thalamic hemorrhage using positron CT and 15 O labeled gas steady-state inhalation method. CBF reduction was limited around the thalamus in the small sized hematoma. CBF were significantly diminished in the mean cortical, parietal, temporal, basal ganglia and thalamic area ipsilateral and cerebellar cortex contralateral to the medium sized hematoma. There was bilateral and diffuse CBF reduction in the large sized hematoma which was caused by increased intracranial pressure. CMRO 2 value were similary changed as CBF. OEF change showed within normal limit. Diffuse CBV reduction was observed in the large sized hematoma. This reduction was the result of decreased vascular bed caused by mass effect of the hematoma and hydrocephalus. Effect of surgical treatment such as ventricular drainage and hematoma evacuation were also discussed in correlation to CBF in some case using positron and single photon ECT. (author)

The Effect of Vascular Neuropathology on Late-life Cognition: Results from the SMART Project.

Science.gov (United States)

Kryscio, R J; Abner, E L; Nelson, P T; Bennett, D; Schneider, J; Yu, L; Hemmy, L S; Lim, K O; Masaki, K; Cairns, N; Xiong, C; Woltjer, R; Dodge, H H; Tyas, S; Fardo, D W; Lou, W; Wan, L; Schmitt, F A

2016-06-01

Cerebral vascular pathology may contribute to cognitive decline experienced by some elderly near death. Given evidence for mixed neuropathologies in advanced age, preventing or reducing cerebrovascular burden in late life may be beneficial. To correlate measures of cerebral vascular pathology with cognitive trajectories. Observational study. A cohort of 2,274 individuals who came to autopsy at a mean age of 89.3 years and 82 percent of whom had at least two cognitive assessments within the last six years of life was compiled from six centers conducting longitudinal studies. For each cognitive domain: immediate and delayed memory, language, and naming, three trajectories were examined: good, intermediate, and poor cognition. The probability of a participant belonging to each trajectory was associated with measures of cerebral vascular pathology after adjustment for demographics, APOE, and Alzheimer neuropathology. A large proportion of the cohort (72-94%) experienced good or intermediate cognition in the four domains examined. The presence of arteriolosclerosis and the presence of lacunar infarcts doubled the odds of belonging to the poor cognitive trajectory for language when compared to the good trajectory. The presence of lacunar infarcts increased the odds of an intermediate or poor trajectory for immediate and delayed recall while the presence of large artery infarcts increased the odds of poor trajectories for all four cognitive domains examined. Microinfarcts and cerebral amyloid angiopathy had little effect on the trajectories. Indicators of cerebral vascular pathology act differently on late life cognition.

Study of cerebral vascular diseases with radioisotopes in cerebral atherosclerotical subjects and/for subjects with sequelae of cerebral stroke, before and after use of the association piracetam-dihydroergotoxine

International Nuclear Information System (INIS)

Lara, P.F.; Ferreira, A.; Paulillo, L.F.; Cukierman, M.

1985-01-01

Twently subjects with cerebral sclerosis and/or sequelas of cerebral stroke were studied, before and after use of piracetam-dihydroergotoxine. We performed the complete hemispheric cerebral blood flow and cerebral scintigraphy, beyond clinical and neurological examination. Scintigraphies were unchanged. Cerebral circulation times, or both hemispheres, diminished. This occurred, probably, in relation with metabolic effects of both pharmaceutical drugs. The alpha sympatolytic and modulatory effects of dihydroergotoxine should be considered. (author) [pt

Prognosis after cerebral ischaemia of arterial origin: clinical characteristics and genetic information

NARCIS (Netherlands)

Achterberg, S.

2013-01-01

Background. Patients who have suffered from cerebral ischemia have a high risk of recurrent vascular events. Predictive models based on classical risk factors typically have limited prognostic value. Given that cerebral ischemia has a heritable component, addition of genetic information might

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

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Caneda Marco Aurélio Gralha de

2006-01-01

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

Cerebral vasculitis and its simulators. Diagnostic and interventional radiology

International Nuclear Information System (INIS)

Ishimaru, Hideki; Nakajima, Kazuaki; Matsuoka, Yohjiro; Sakamoto, Ayami; Sakugawa, Takayuki; Morikawa, Minoru; Inuzuka, Michiko; Kimura, Seigo

2009-01-01

Cerebral vasculitis, although rare in general, is an important cause of cerebral ischemia, because the treatment strategy is different from that of usual cerebral infarction. On the other hand, a variety of common and uncommon nonvasculitic disorders may mimic vasculitis angiographically or clinically. It is also important to distinguish these vasculitis simulators from true vasculitis in order to avoid the unnecessary and harmful side effects of corticosteroid and immunosuppressant, the mainstay of drug therapy for vasculitis. The diagnosis is often difficult. Angiography is expected to demonstrate the underlying vascular pathology; however, many vasculitides affect small arteries beyond the spatial resolution of conventional angiography. The most important role of the diagnostic imaging is the identification of brain lesions consistent with cerebral vasculitis. Multiple lesions in more than one vascular territory should raise this suspicion, although no specific pattern for this entity exists. In large and medium-sized vessel vasculitis, MRI can directly demonstrate mural thickening and enhancement, which is considered to specific for active inflammation. We propose here a classification for cerebral vasculitis and simulators according to the size of the affected brain vessels, which would help us to make a differential diagnosis. We also review the endovascular techniques for this entity, and its indications. (author)

Enfermedad de Chagas en Nicaragua

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Carlos N. Talavera - López

2008-04-01

Full Text Available LA ENFERMEDAD DE CHAGAS ES UN PROBLEMA DE SALUD pública en toda Latinoamérica; alrededor de 20 millones de personas están infectadas y 200 millones están en riesgo de contraer la enfermedad. En 2006, la prevalencia en Centroamérica era del 7%. Actualmente no existe vacuna contra el protozoo y el tratamiento disponible resulta, aparte de poco efectivo, muy tóxico para el paciente. Los programas de control de vectores han ayudado a reducir los índices de infestación en Latinoamérica, pero aún falta mucho por hacer. En Nicaragua, la enfermedad de Chagas está subvalorada y los trabajos publicados son muy pocos. Es necesario investigar sobre esta enfermedad en nuestro país con otro enfoque, uno que no subvalore la enfermedad y ayude a desarrollar métodos diagnósticos y posibles tratamientos. Este artículo recopila información sobre los trabajos realizados porlos grupos más importantes de investigación en Chagas de Nicaragua en cuanto a epidemiología, control vectorial, diagnóstico y caracterización molecular.

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

International Nuclear Information System (INIS)

Kang, Do Young; Park, Kyung Won; Kim, Jae Woo

2003-01-01

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

Neuroimaging of cerebral vasculitis

International Nuclear Information System (INIS)

Wengenroth, M.; Saam, T.; Haehnel, S.

2016-01-01

Cerebral vasculitis can have a variety of origins. Furthermore, there are no vasculitis-specific symptoms or imaging signs and vasculitis of the CNS can mimic many other neurological diseases, which require different treatment approaches. Thus, the clinical and radiological diagnosis of cerebral vasculitis is challenging. Magnetic resonance imaging (MRI) and MR angiography (MRA) should be the radiological imaging methods of choice to assess the degree of parenchymal damage and to detect vessel wall changes. If the results are unclear digital subtraction angiography (DSA) should be pursued in order to also detect changes in medium sized vessels. Vasculitis of small vessels cannot be detected by vascular imaging and requires brain or leptomeningeal biopsy. In this review we present the current diagnostic approach and a variety of imaging findings in cerebral vasculitis and discuss the main radiological differential diagnoses. (orig.) [de

Malaria cerebral Cerebral malaria

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Carlos Hugo Zapata Zapata

2003-03-01

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

Cerebral Amyloid Angiopathy

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Mahmut Edip Gürol

2009-03-01

Full Text Available Cerebral amyloid angiopathy (CAA is characterized by the accumulation of amyloid beta-peptides (Ab in the walls of leptomeningeal arteries, arterioles, and veins. Despite the fact that these pathological changes were first described in 1909, major advancement in our understanding of the clinicoradiological manifestations, neurobiology, and course of CAA has occurred only during the last 30 years. No significant associations have been shown between CAA and other systemic/visceral amyloidoses or vascular risk factors, including hypertension. CAA is well known as the most common cause of spontaneous and anticoagulant-related lobar parenchymal ICH in the elderly. It also causes lobar cerebral microbleeds (CMBs, small dot-like dark susceptibility artifacts visible with gradient recalled echo (GRE-magnetic resonance imaging (MRI. CMBs are important markers of disease severity and predictors of CAA progression. Amyloid angiopathy is also a common cause of ischemic microvascular white matter disease (WMD and deep cerebral infarctions. Such WMD is defined as subcortical and periventricular white matter changes without obvious infarction, as well as a dark appearance on computerized tomography (CT and a bright appearance on fluid attenuated inversion recovery (FLAIR-MRI. CAA-related vascular dysfunction, with its hemorrhagic and ischemic complications, is a recognized contributor to vascular cognitive impairment in the elderly, an independent effect that is synergistically increased by Alzheimer pathologies, such as plaques and tangles. A set of clinicoradiological criteria was established for the accurate diagnosis of CAA. According to the Boston Criteria, patients aged 55 years and older with multiple hemorrhages (on CT or GRE-MRI restricted to the lobar, cortical, or corticosubcortical regions (cerebellar hemorrhage allowed are diagnosed as probable CAA when no other etiology is found; a single hemorrhage in the same region is classified as possible

Hydrostatic determinants of cerebral perfusion

International Nuclear Information System (INIS)

Wagner, E.M.; Traystman, R.J.

1986-01-01

We examined the cerebral blood flow response to alterations in perfusion pressure mediated through decreases in mean arterial pressure, increases in cerebrospinal fluid (CSF) pressure, and increases in jugular venous (JV) pressure in 42 pentobarbital anesthetized dogs. Each of these three pressures was independently controlled. Cerebral perfusion pressure was defined as mean arterial pressure minus JV or CSF pressure, depending on which was greater. Mean hemispheric blood flow was measured with the radiolabeled microsphere technique. Despite 30-mm Hg reductions in mean arterial pressure or increases in CSF or JV pressure, CBF did not change as long as the perfusion pressure remained greater than approximately 60 mm Hg. However, whenever perfusion pressure was reduced to an average of 48 mm Hg, cerebral blood flow decreased 27% to 33%. These results demonstrate the capacity of the cerebral vascular bed to respond similarly to changes in the perfusion pressure gradient obtained by decreasing mean arterial pressure, increasing JV pressure or increasing CSF pressure, and thereby support the above definition of cerebral perfusion pressure

A quantitative brain map of experimental cerebral malaria pathology.

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Patrick Strangward

2017-03-01

Full Text Available The murine model of experimental cerebral malaria (ECM has been utilised extensively in recent years to study the pathogenesis of human cerebral malaria (HCM. However, it has been proposed that the aetiologies of ECM and HCM are distinct, and, consequently, no useful mechanistic insights into the pathogenesis of HCM can be obtained from studying the ECM model. Therefore, in order to determine the similarities and differences in the pathology of ECM and HCM, we have performed the first spatial and quantitative histopathological assessment of the ECM syndrome. We demonstrate that the accumulation of parasitised red blood cells (pRBCs in brain capillaries is a specific feature of ECM that is not observed during mild murine malaria infections. Critically, we show that individual pRBCs appear to occlude murine brain capillaries during ECM. As pRBC-mediated congestion of brain microvessels is a hallmark of HCM, this suggests that the impact of parasite accumulation on cerebral blood flow may ultimately be similar in mice and humans during ECM and HCM, respectively. Additionally, we demonstrate that cerebrovascular CD8+ T-cells appear to co-localise with accumulated pRBCs, an event that corresponds with development of widespread vascular leakage. As in HCM, we show that vascular leakage is not dependent on extensive vascular destruction. Instead, we show that vascular leakage is associated with alterations in transcellular and paracellular transport mechanisms. Finally, as in HCM, we observed axonal injury and demyelination in ECM adjacent to diverse vasculopathies. Collectively, our data therefore shows that, despite very different presentation, and apparently distinct mechanisms, of parasite accumulation, there appear to be a number of comparable features of cerebral pathology in mice and in humans during ECM and HCM, respectively. Thus, when used appropriately, the ECM model may be useful for studying specific pathological features of HCM.

A quantitative brain map of experimental cerebral malaria pathology.

Science.gov (United States)

Strangward, Patrick; Haley, Michael J; Shaw, Tovah N; Schwartz, Jean-Marc; Greig, Rachel; Mironov, Aleksandr; de Souza, J Brian; Cruickshank, Sheena M; Craig, Alister G; Milner, Danny A; Allan, Stuart M; Couper, Kevin N

2017-03-01

The murine model of experimental cerebral malaria (ECM) has been utilised extensively in recent years to study the pathogenesis of human cerebral malaria (HCM). However, it has been proposed that the aetiologies of ECM and HCM are distinct, and, consequently, no useful mechanistic insights into the pathogenesis of HCM can be obtained from studying the ECM model. Therefore, in order to determine the similarities and differences in the pathology of ECM and HCM, we have performed the first spatial and quantitative histopathological assessment of the ECM syndrome. We demonstrate that the accumulation of parasitised red blood cells (pRBCs) in brain capillaries is a specific feature of ECM that is not observed during mild murine malaria infections. Critically, we show that individual pRBCs appear to occlude murine brain capillaries during ECM. As pRBC-mediated congestion of brain microvessels is a hallmark of HCM, this suggests that the impact of parasite accumulation on cerebral blood flow may ultimately be similar in mice and humans during ECM and HCM, respectively. Additionally, we demonstrate that cerebrovascular CD8+ T-cells appear to co-localise with accumulated pRBCs, an event that corresponds with development of widespread vascular leakage. As in HCM, we show that vascular leakage is not dependent on extensive vascular destruction. Instead, we show that vascular leakage is associated with alterations in transcellular and paracellular transport mechanisms. Finally, as in HCM, we observed axonal injury and demyelination in ECM adjacent to diverse vasculopathies. Collectively, our data therefore shows that, despite very different presentation, and apparently distinct mechanisms, of parasite accumulation, there appear to be a number of comparable features of cerebral pathology in mice and in humans during ECM and HCM, respectively. Thus, when used appropriately, the ECM model may be useful for studying specific pathological features of HCM.

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

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Ivan L. Angulo

2007-09-01

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

Modeling cerebral blood flow during posture change from sitting to standing

DEFF Research Database (Denmark)

Ottesen, Johnny T.; Olufsen, M.; Tran, H.T.

2004-01-01

extremities, the brain, and the heart. We use physiologically based control mechanisms to describe the regulation of cerebral blood flow velocity and arterial pressure in response to orthostatic hypotension resulting from postural change. To justify the fidelity of our mathematical model and control......Abstract Hypertension, decreased cerebral blood flow, and diminished cerebral blood flow velocity regulation, are among the first signs indicating the presence of cerebral vascular disease. In this paper, we will present a mathematical model that can predict blood flow and pressure during posture...

Functional stability of cerebral circulatory system

Science.gov (United States)

Moskalenko, Y. Y.

1980-01-01

The functional stability of the cerebral circulation system seems to be based on the active mechanisms and on those stemming from specific of the biophysical structure of the system under study. This latter parameter has some relevant criteria for its quantitative estimation. The data obtained suggest that the essential part of the mechanism for active responses of cerebral vessels which maintains the functional stability of this portion of the vascular system, consists of a neurogenic component involving central nervous structures localized, for instance, in the medulla oblongata.

Cigarette smoking impairs nitric oxide-mediated cerebral blood flow increase: Implications for Alzheimer's disease

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Noboru Toda

2016-08-01

Full Text Available Cerebral blood flow is mainly regulated by nitrergic (parasympathetic, postganglionic nerves and nitric oxide (NO liberated from endothelial cells in response to shear stress and stretch of vasculature, whereas sympathetic vasoconstrictor control is quite weak. On the other hand, peripheral vascular resistance and blood flow are mainly controlled by adrenergic vasoconstrictor nerves; endothelium-derived NO and nitrergic nerves play some roles as vasodilator factors. Cigarette smoking impairs NO synthesis in cerebral vascular endothelial cells and nitrergic nerves leading to interference with cerebral blood flow and glucose metabolism in the brain. Smoking-induced cerebral hypoperfusion is induced by impairment of synthesis and actions of NO via endothelial nitric oxide synthase (eNOS/neuronal NOS (nNOS inhibition and by increased production of oxygen radicals, resulting in decreased actions of NO on vascular smooth muscle. Nicotine acutely and chronically impairs the action of endothelial NO and also inhibits nitrergic nerve function in chronic use. Impaired cerebral blood supply promotes the synthesis of amyloid β that accelerates blood flow decrease. This vicious cycle is thought to be one of the important factors involving in Alzheimer's disease (AD. Quitting smoking is undoubtedly one of the important ways to prevent and delay the genesis or slow the progress of impaired cognitive function and AD.

Exercise induces cerebral VEGF and angiogenesis via the lactate receptor HCAR1

DEFF Research Database (Denmark)

Morland, Cecilie; Andersson, Krister A.; Haugen, Oyvind P.

2017-01-01

-like cells along intracerebral microvessels. Activation of HCAR1 enhances cerebral vascular endothelial growth factor A (VEGFA) and cerebral angiogenesis. High-intensity interval exercise (5 days weekly for 7 weeks), as well as L-lactate subcutaneous injection that leads to an increase in blood lactate...

Doença de Moyamoya e anestesia com sevoflurano fora do centro cirúrgico: relato de caso Enfermedad de Moyamoya y anestesia con sevoflurano fuera del centro quirúrgico: relato de caso Moyamoya disease and sevoflurane anesthesia outside the surgery center: case report

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Sheila Braga Machado

2002-06-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: A doença de Moyamoya é uma desordem cerebrovascular progressiva que representa um desafio anestésico em virtude da precária circulação cerebral destes pacientes, constituindo-se numa importante causa de acidente vascular cerebral em indivíduos jovens. O objetivo deste relato é apresentar o caso de um paciente com doença de Moyamoya que foi submetido à anestesia geral com sevoflurano para procedimento diagnóstico fora do centro cirúrgico. RELATO DO CASO: Criança com 13 anos, estado físico ASA IV, portadora de doença de Moyamoya com seqüela neurológica após três acidentes vasculares cerebrais, insuficiência renal crônica e hipertensão arterial sistêmica, submetida à endoscopia digestiva alta. Em decúbito dorsal e após monitorização, realizou-se indução inalatória pela cânula de traqueostomia com sevoflurano (aumento gradual da concentração inspiratória até 6% e mistura de oxigênio/óxido nitroso a 50%. Um cateter venoso foi inserido para infusão de solução glicosada a 5%. Foi realizada ventilação controlada manual, sendo a manutenção da anestesia feita com sevoflurano a 4% e mistura de oxigênio/óxido nitroso a 50%. Ao final do procedimento os agentes anestésicos foram descontinuados simultaneamente e foi administrado oxigênio a 100%. A anestesia foi satisfatória, com boa estabilidade hemodinâmica, sem ocorrência de complicações durante o procedimento e com despertar precoce. CONCLUSÕES: O sevoflurano pode oferecer novas perspectivas para a anestesia inalatória em pacientes com doença neurológica que realizam procedimento ambulatorial, já que permite boa estabilidade hemodinâmica e despertar precoce, preservando a fisiologia cerebral.JUSTIFICATIVA Y OBJETIVOS: La enfermedad de Moyamoya es un desorden cerebrovascular progresivo que representa un desafío anestésico en virtud de la precaria circulación cerebral de estos pacientes, constituyéndose una importante

Value of three-dimensional computed tomography in screening cerebral aneurysms

Energy Technology Data Exchange (ETDEWEB)

Yamaguchi, Tamaki; Sugiura, Yusuke; Suzuki, Atsushi; Yamagata, Yoshitaka [Hyogo Medical Coll. (Japan)

1997-10-01

We performed three-dimensional computed tomography (3D-CT) in 6 patients of cerebral aneurysm. Prior cerebral angiography showed a total of 17 aneurysms. 3D-CT alone detected 10 cerebral aneurysm (59%). It was possible to identify aneurysms larger than 10 mm even when located near the circle of Willis. It was difficult to identify aneurysms when smaller than 7 mm regardless of their location. 3D-CT was of limited value in detecting cerebral aneurysms, particularly when located near the circle of Willis with complex vascular network. As cases of oculomotor palsy may be caused by lesions other than cerebral aneurysm, we advocate that 3D-CT be performed after magnetic resonance imaging (MRI) in screening cases of suspected cerebral aneurysm. (author)

Proteólisis cerebral del péptido amiloide-ß: Relevancia de la enzima degradadora de insulina en la enfermedad de Alzheimer Cerebral proteolysis of amyloid-ß peptide: Relevance of insulin-degrading enzyme in Alzheimer's disease

Directory of Open Access Journals (Sweden)

María Celeste Leal

2009-10-01

Full Text Available El aumento global de la expectativa de vida convierte a la enfermedad de Alzheimer (EA en un problema creciente. Una de las características distintivas de EA es la acumulación excesiva del péptido amiloide ß (Aß en el cerebro. En los últimos años se ha fortalecido el concepto de que la degradación de Aß por proteasas in situ es un mecanismo importante que previene su acumulación cerebral. Datos bioquímicos y genéticos mostraron que la enzima degradadora de insulina (IDE participa en la homeostasis de Aß e insulina. La expresión y la actividad de IDE están significativamente disminuidas en cerebros con EA comparados con controles de igual edad. Además, IDE se deposita con Aß en placas seniles y vasos, indicando un grosero cambio conformacional producto de distintos mecanismos post-traduccionales. Estas alteraciones en la distribución y actividad de IDE resultan en una insuficiente degradación de Aß e insulina y promueven la formación de oligómeros de Aß y la resistencia a la hormona, procesos que convergen hacia la neurodegeneración. El estudio de los mecanismos de eliminación de Aß cerebral no sólo ayudará a comprender la patogenia de EA sino que permitirá una mejor interpretación de los ensayos clínicos en curso y el desarrollo de nuevas estrategias terapéuticas.The global increase in life expectancy turns Alzheimer's disease (AD into a growing problem. One of the distinctive features of AD is the excessive accumulation of amyloid-ß (Aß peptide in the brain. In recent years, a concept that has gained strength is that degradation of Aß by proteases in situ is an important mechanism that prevents cerebral peptide accumulation. Biochemical and genetic data have shown that insulin-degrading enzyme (IDE participates in Aß and insulin homeostasis. IDE expression and activity are significantly decreased in AD brains compared to age-matched controls. Also, IDE is deposited with Aß in senile plaques and blood vessels

Magnetic resonance angiography in suspected cerebral vasculitis

International Nuclear Information System (INIS)

Demaerel, Philippe; De Ruyter, Nele; Wilms, Guido; Maes, Frederik; Velghe, Beatrijs

2004-01-01

The purpose of this study was to determine the technical capacity and diagnostic accuracy of 3D time-of-flight magnetic resonance angiography (MRA) in suspected cerebral vasculitis in a retrospective analysis of MRA and digital subtraction angiography (DSA) in 14 young patients with clinical and/or radiological suspicion of cerebral vasculitis. A total of nine arteries were evaluated in each patient. Consensus review of DSA by three observers was the reference standard. The sensitivity for detecting a stenosis varied from 62 to 79% for MRA and from 76 to 94% for DSA, depending on the observer. The specificity for detecting a stenosis varied from 83 to 87% for MRA and from 83 to 97% for DSA. Using the criterion ''more than two stenoses in at least two separate vascular distributions'' to consider the examination as being true positive, the false-positive rates for MRA and DSA were comparable. MRA plays a role as the first angiographical examination in the diagnostic work-up of suspected cerebral vasculitis. When more than two stenoses in at least two separate vascular distributions are depicted on MRA, DSA is not expected to add a significant diagnostic contribution in a patient with suspected cerebral vasculitis. DSA remains necessary when MRA is normal or when less than three stenoses are seen. (orig.)

Magnetic resonance angiography in suspected cerebral vasculitis

Energy Technology Data Exchange (ETDEWEB)

Demaerel, Philippe; De Ruyter, Nele; Wilms, Guido [Department of Radiology, Universitair Ziekenhuis, KU Leuven, 3000, Leuven (Belgium); Maes, Frederik [Department of Medical Imaging Computing, Universitair Ziekenhuis, KU Leuven, 3000, Leuven (Belgium); Velghe, Beatrijs [Department of Radiology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600, Genk (Belgium)

2004-06-01

The purpose of this study was to determine the technical capacity and diagnostic accuracy of 3D time-of-flight magnetic resonance angiography (MRA) in suspected cerebral vasculitis in a retrospective analysis of MRA and digital subtraction angiography (DSA) in 14 young patients with clinical and/or radiological suspicion of cerebral vasculitis. A total of nine arteries were evaluated in each patient. Consensus review of DSA by three observers was the reference standard. The sensitivity for detecting a stenosis varied from 62 to 79% for MRA and from 76 to 94% for DSA, depending on the observer. The specificity for detecting a stenosis varied from 83 to 87% for MRA and from 83 to 97% for DSA. Using the criterion ''more than two stenoses in at least two separate vascular distributions'' to consider the examination as being true positive, the false-positive rates for MRA and DSA were comparable. MRA plays a role as the first angiographical examination in the diagnostic work-up of suspected cerebral vasculitis. When more than two stenoses in at least two separate vascular distributions are depicted on MRA, DSA is not expected to add a significant diagnostic contribution in a patient with suspected cerebral vasculitis. DSA remains necessary when MRA is normal or when less than three stenoses are seen. (orig.)

Effects of forskolin on cerebral blood flow: implications for a role of adenylate cyclase

International Nuclear Information System (INIS)

Wysham, D.G.; Brotherton, A.F.; Heistad, D.D.

1986-01-01

We have studied cerebral vascular effects of forskolin, a drug which stimulates adenylate cyclase and potentiates dilator effects of adenosine in other vascular beds. Our goals were to determine whether forskolin is a cerebral vasodilator and whether it potentiates cerebral vasodilator responses to adenosine. We measured cerebral blood flow with microspheres in anesthetized rabbits. Forskolin (10 micrograms/kg per min) increased blood flow (ml/min per 100 gm) from 39 +/- 5 (mean +/- S.E.) to 56 +/- 9 (p less than 0.05) in cerebrum, and increased flow to myocardium and kidney despite a decrease in mean arterial pressure. Forskolin did not alter cerebral oxygen consumption, which indicates that the increase in cerebral blood flow is a direct vasodilator effect and is not secondary to increased metabolism. We also examined effects of forskolin on the response to infusion of adenosine. Cerebral blood flow was measured during infusion of 1-5 microM/min adenosine into one internal carotid artery, under control conditions and during infusion of forskolin at 3 micrograms/kg per min i.v. Adenosine alone increased ipsilateral cerebral blood flow from 32 +/- 3 to 45 +/- 5 (p less than 0.05). Responses to adenosine were not augmented during infusion of forskolin. We conclude that forskolin is a direct cerebral vasodilator and forskolin does not potentiate cerebral vasodilator responses to adenosine

Estimation of blood volume difference between bilateral cerebral hemispheres by means of subtraction method

International Nuclear Information System (INIS)

Ueno, Ichiro

1983-01-01

It would be admitted that by measuring radioactivity of the head after intravenous injection of RI some information could be afforded concerning the cerebral vascular bed. After intravenous injection of sup(99m)Tc-pertechnetate (15mCi), an anterior view scintiscanning was made using a gamma camera combined with a computer system. Two ROIs of about 30 cm 2 were set bilateral symmetrically and a count rate curve of each ROI was obtained. The brain transit time (BTT) was calculated from first derivative of the initial count rate courve. As an index devoting difference between vascular bed of each hemisphere, the vascular bed difference index (VBDI) was introduced BTT and VBDI were calculated in 104 subjects including 11 normal controls. In most of brain tumor, cerebral hemorrhage, severe head injury and cerebral aneurysm BTTs were prolonged in affected hemispheres. However, in a half of cerebral infarction cases BTTs were rather shortened on the affected side. In normal controls, the absolute value of VBDI was [0.16 +- 0.06(S.D.)]. In cases of brain tumor, cerebral hemorrhage and severe head injury, VBDI showed a significant deviation from the normal range, taking plus value. This results suggest, according to the definition of VBDI, vascular beds of the affected hemisphere are abnormally decreased compared with those of non-affected side. In cases of arteriovenous malformation VBDIs were increased on the affected side, reflecting enlarged tangle of arteriols and venous vessels. On the other hand, in cases of cerebral infarction, VBDI varied from case to case, making it difficult to get some conclusion from the present data. VBDI, however, invariably decreased in cases in which the occlusion of arteries were definitely confirmed by angiography

The pathology and pathophysiology of vascular dementia.

Science.gov (United States)

Kalaria, Raj N

2017-12-19

Vascular dementia (VaD) is widely recognised as the second most common type of dementia. Consensus and accurate diagnosis of clinically suspected VaD relies on wide-ranging clinical, neuropsychological and neuroimaging measures in life but more importantly pathological confirmation. Factors defining subtypes of VaD include the nature and extent of vascular pathologies, degree of involvement of extra and intracranial vessels and the anatomical location of tissue changes as well as time after the initial vascular event. Atherosclerotic and cardioembolic diseases combined appear the most common subtypes of vascular brain injury. In recent years, cerebral small vessel disease (SVD) has gained prominence worldwide as an important substrate of cognitive impairment. SVD is characterised by arteriolosclerosis, lacunar infarcts and cortical and subcortical microinfarcts and diffuse white matter changes, which involve myelin loss and axonal abnormalities. Global brain atrophy and focal degeneration of the cerebrum including medial temporal lobe atrophy are also features of VaD similar to Alzheimer's disease. Hereditary arteriopathies have provided insights into the mechanisms of dementia particularly how arteriolosclerosis, a major contributor of SVD promotes cognitive impairment. Recently developed and validated neuropathology guidelines indicated that the best predictors of vascular cognitive impairment were small or lacunar infarcts, microinfarcts, perivascular space dilation, myelin loss, arteriolosclerosis and leptomeningeal cerebral amyloid angiopathy. While these substrates do not suggest high specificity, VaD is likely defined by key neuronal and dendro-synaptic changes resulting in executive dysfunction and related cognitive deficits. Greater understanding of the molecular pathology is needed to clearly define microvascular disease and vascular substrates of dementia. Copyright © 2017 Elsevier Ltd. All rights reserved.

Vasodilatadores en la hipertensión pulmonar: selectividad por el territorio vascular, por oxígeno y efectos antiproliferativos

OpenAIRE

Morales Cano, Daniel

2016-01-01

La Hipertensión Pulmonar (HP) es una enfermedad crónica y progresiva. La HP presenta una compleja fisiopatología caracterizada por vasoconstricción, remodelado vascular y trombosis. Las terapias actuales muestran efectos beneficiosos, sin embargo presentan también importantes limitaciones: 1) pobre selectividad pulmonar, 2) modesta eficacia vasodilatadora, 3) desacoplamiento de la ventilación/perfusión (V/Q) e 4) incapacidad para prevenir la progresión de la enfermedad. La quercet...

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

Science.gov (United States)

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

2015-12-15

Vitamin D plays vital roles in human health and recent studies have shown its beneficial effect on brain functioning. The present study was designed to evaluate the association of vitamin D with vascular dementia (VaD) due to cerebral small vessel disease (SVD) in Asian Indian population. 140 VaD patients aged ≥ 60 years with neuroimaging evidence of SVD, and 132 age and gender-matched controls, were investigated. Vitamin D status was estimated by measuring serum 25-hydroxy vitamin D. Logistic regression model revealed that deficient levels of vitamin D (vitamin D deficiency and insufficiency (12-20 ng/ml), the odds were increased to 31.6-fold and 14.4-fold, respectively. However, in hypertensives with vitamin D sufficiency (>20 ng/ml), the odds of VaD were increased by 3.8-fold only. Pearson correlation showed that serum vitamin D was inversely associated with systolic and diastolic blood pressure (r=-0.401 and -0.411, pvitamin D-deficient subjects. Since the combined presence of hypertension and vitamin D deficiency increases the probability of developing VaD, screening for vitamin D status in addition to regular monitoring of blood pressure, could reduce the risk of VaD associated with cerebral SVD in the elderly Asian Indian subjects. Copyright © 2015 Elsevier B.V. All rights reserved.

Transient acute renal failure and functional hemispheric depression after cerebral arteriography in diabetic patients

DEFF Research Database (Denmark)

Olsen, Tom Skyhøj; Lund, P; Praestholm, J

1981-01-01

Cerebral angiography was carried out in two diabetic patients in the evaluation of minor vascular ischemic episodes. A transient acute renal failure following cerebral angiography was accompanied by a transient comatose episode with severe unilateral neurological deficits. A functional depression...

Absceso intramedular en paciente con enfermedad de Rendu-Osler-Weber Spinal abscess in a patient with hereditary hemorrhagic telangiectasia

Directory of Open Access Journals (Sweden)

Lorena V Maldonado

2007-12-01

Full Text Available La enfermedad de Rendu-Osler-Weber es una enfermedad autosómica dominante que se manifiesta por telangiectasias en piel y mucosas y malformaciones arteriovenosas en diversos órganos. El compromiso neurológico puede ocurrir por la presencia de malformaciones arterio-venosas cerebrales, hemorragia intracraneal, y más habitualmente por accidentes cerebrovasculares isquémicos y abscesos cerebrales secundarios a embolia paradojal, en pacientes con malformaciones arteriovenosas pulmonares. El absceso intramedular es una entidad rara, inusual como complicación de la enfermedad de Rendu-Osler-Weber. Presentamos el caso de una mujer de 56 años de edad, con antecedentes familiares de enfermedad de Rendu-Osler- Weber, que ingresó a Terapia Intensiva con cuadriplejia aguda e hipoxemia, en quien se diagnosticó fístulas arteriovenosas pulmonares y un absceso intramedular cervical.Rendu-Osler-Weber syndrome is an autosomal dominant disorder characterized by multiple skin and mucosal telangiectasis and multiorgan arteriovenous malformations. Neurological manifestations may occur because of cerebral arteriovenous malformations, intracranial hemorrhage, and most commonly by ischemic stroke and brain abscess secondary to paradoxical embolization in patients with pulmonary arteriovenous malformations. Intramedullary abscess is a rare, unusual condition, in Rendu-Osler-Weber syndrome. We report the case of a 56 years old woman, with a familial history of Rendu-Osler-Weber syndrome, admitted to intensive care with acute quadriplegia and hypoxemia. Our diagnosis was pulmonary arteriovenous malformations and intramedullary abscess.

Vascular neurocognitive disorders and the vascular risk factors

Directory of Open Access Journals (Sweden)

Carmen V. Albu

2018-04-01

Full Text Available Dementias are clinical neurodegenerative diseases characterized by permanent and progressive transformation of cognitive functions such as memory, learning capacity, attention, thinking, language, passing judgments, calculation or orientation. Dementias represent a relatively frequent pathology, encountered at about 10% of the population of 65-year olds and 20% of the population of 80-year olds. This review presents the main etiological forms of dementia, which include Alzheimer form of dementia, vascular dementia, dementia associated with alpha-synucleionopathies, and mixed forms. Regarding vascular dementia, the risk factors are similar to those for an ischemic or hemorrhagic cerebrovascular accident: arterial hypertension, diabetes mellitus, dyslipidemia, smoking, obesity, age, alcohol consumption, cerebral atherosclerosis/ arteriosclerosis. Several studies show that efficient management of the vascular risk factors can prevent the expression and/ or progression of dementia. Thus, lifestyle changes such as stress reduction, regular physical exercise, decreasing dietary fat, multivitamin supplementation, adequate control of blood pressure and serum cholesterol, and social integration and mental stimulation in the elderly population are important factors in preventing or limiting the symptoms of dementia, a disease with significant individual, social, and economic implications.

Effects of Cerebral Ischemia in Mice Deficient in Neuronal Nitric Oxide Synthase

Science.gov (United States)

Huang, Zhihong; Huang, Paul L.; Panahian, Nariman; Dalkara, Turgay; Fishman, Mark C.; Moskowitz, Michael A.

1994-09-01

The proposal that nitric oxide (NO) or its reactant products mediate toxicity in brain remains controversial in part because of the use of nonselective agents that block NO formation in neuronal, glial, and vascular compartments. In mutant mice deficient in neuronal NO synthase (NOS) activity, infarct volumes decreased significantly 24 and 72 hours after middle cerebral artery occlusion, and the neurological deficits were less than those in normal mice. This result could not be accounted for by differences in blood flow or vascular anatomy. However, infarct size in the mutant became larger after endothelial NOS inhibition by nitro-L-arginine administration. Hence, neuronal NO production appears to exacerbate acute ischemic injury, whereas vascular NO protects after middle cerebral artery occlusion. The data emphasize the importance of developing selective inhibitors of the neuronal isoform.

Cerebral hemodynamics in adult ischemic-type patients with moyamoya disease compared with those of atherothrombotic middle cerebral artery occlusion

International Nuclear Information System (INIS)

Idei, Masaru; Yamane, Kanji; Nishida, Masahiro; Manabe, Kazufumi; Yokota, Akira

2005-01-01

We measured regional cerebral blood flow (rCBF) in adult ischemic-type patients with moyamoya disease and in patients with atherothrombotic middle cerebral artery occlusion (MCAO) to investigate cerebral hemodynamics in adult ischemic-type of moyamoya disease. In this study we measured rCBF and regional cerebro-vascular response (rCVR) using acetazolamide by Xe-non-enhanced CT. Our subjects consisted of 15 adult ischemic-type patients with moyamoya disease and 27 atherothrombotic stroke patients with proximal occlusion of the middle cerebral artery. The region of inter est was conducted in the anterior cerebral artery, middle cerebral artery and posterior cerebral artery territories as well as basal ganglia regions. rGBF was preserved in all regions of patients with moyamoya disease. However, rCVR severely decreased in the anterior circulation territory in patients with moyamoya disease compared with those of MCAO. These results suggest that rCBF in the anterior circulation territory of adult ischemic-type patients with moyamoya disease is preserved by vasodilation of the cerebral arteries, while cerebral hemodynamic reserve capacity is severely reduced. The results indicated that basal moyamoya vessels are dilated. These findings may be one of the reasons why stroke occurs more frequently in adult than child patients with moyamoya disease. (author)

Perfil Clínico-Epidemiológico de Pacientes que inician Terapia Intensiva con Estatinas para La Prevención Secundaria de Enfermedad Vascular en España

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Diego Macías Saint Gerons

2015-01-01

Full Text Available Las nuevas recomendaciones respecto a la utilización de estatinas potentes y/o dosis altas (terapia intensiva para el tratamiento de la enfermedad cardiovascular se han basado en la extrapolación de los resultados de los ensayos clínicos. El objetivo fue describir el perfil clínico-epidemiológico de los pacientes que inician tratamiento con estatinas para la prevención secundaria en España y estudiar qué factores determinan la utilización de estatinas en terapia intensiva. Métodos: Estudio transversal a partir de 88.751 pacientes ≥45 años con enfermedad cardiovascular que iniciaron tratamiento con estatinas (enero 2007-diciembre 2011. Los tratamientos con dosis superiores a 40 mg/día de simvastatina (o estatina equipotente se consideraron terapia intensiva. Se construyeron modelos de regresión logística multivariante con el fin de examinar la asociación de las variables relacionadas con la prescripción de terapia intensiva respecto al uso de la terapia moderada. Resultados: Se identificó a 16.857 personas adultas que iniciaron tratamiento con estatinas para la prevención secundaria. Los factores predictores para el inicio de terapia intensiva fueron el año de prescripción, sexo masculino (odds ratio ajustada: 1,70; IC95%: 1,44-2,00, edad >75 años (1,39; 1,15-1,69, historia previa de enfermedad isquémica coronaria (1,71; 1,44-2,04, accidente isquémico transitorio de cualquier localización (1,24; 0,97-1,59, tabaquismo (1,62; 1,34-1,95, hipertensión (1,41; 1,20-1,65 y tratamiento reciente con fibratos (2,32; 1,27-4,26. Conclusiones: La utilización de terapia intensiva con estatinas está determinada por el tipo de evento vascular previo y con la edad (>75 años, en los que el balance beneficio-riesgo podría ser discutible. No se encuentran diferencias estadísticamente significativas en función del c-LDL.

Enfermedad de moyamoya, macrocefalia y déficit intelectual en un adolescente

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José Vargas Díaz

2013-03-01

Full Text Available El patrón moyamoya se caracteriza por un estrechamiento crónico progresivo de la porción terminal de la arteria carótida interna o sus principales ramas terminales principalmente. Los niños con moyamoya típicamente se presentan con ictus arteriales isquémicos, o con accidentes isquémicos transitorios. Se presenta el caso clínico de un adolescente, con déficit intelectual y macrocránea, con evidencia en los estudios de resonancia magnética nuclear cerebral de infartos arteriales isquémicos a repetición, e imágenes sugestivas de moyamoya, y se comprueba el patrón moyamoya por angiografía de sustracción digital. Comprobado el diagnóstico de enfermedad de moyamoya, el objetivo con este enfermo fue tratar de mejorar la irrigación cerebral, planteando la necesidad de someter al paciente a cirugía de revascularización, y, mientras esto no fuera posible, usar aspirina como antiagregante plaquetario, en un intento de impedir o disminuir el riesgo de nuevos infartos cerebrales o de accidentes transitorios isquémicos a repetición.

Risk factors for vascular dementia: Hypotension as a key point

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Rita Moretti

2008-04-01

Full Text Available Rita Moretti, Paola Torre, Rodolfo M Antonello, Davide Manganaro, Cristina Vilotti, Gilberto PizzolatoDepartment of Internal Medicine and Clinical Neurology University of Trieste, ItalyAbstract: Physiologically, the cerebral autoregulation system allows maintenance of constant cerebral blood flow over a wide range of blood pressure. In old people, there is a progressive reshape of cerebral autoregulation from a sigmoid curve to a straight line. This implies that any abrupt change in blood pressure will result in a rapid and significant change in cerebral blood flow. Hypertension has often been observed to be a risk factor for vascular dementia (VaD and sometimes for Alzheimer disease although not always. Indeed, high blood pressure may accelerate cerebral white matter lesions, but white matter lesions have been found to be facilitated by excessive fall in blood pressure, including orthostatic dysregulation and postprandial hypotension. Many recent studies observed among other data, that there was a correlation between systolic pressure reduction and cognitive decline in women, which was not accounted for by other factors. Baseline blood pressure level was not significantly related to cognitive decline with initial good cognition. Some researchers speculate that blood pressure reduction might be an early change of the dementing process. The most confounding factor is that low pressure by itself might be a predictor of death; nevertheless, the effect of low blood pressure on cognition is underestimated because of a survival bias. Another explanation is that clinically unrecognized vascular lesions in the brain or atherosclerosis are responsible for both cognitive decline and blood pressure reduction. We discuss the entire process, and try to define a possible mechanism that is able to explain the dynamic by which hypotension might be related to dementia.Keywords: vascular dementia, hypotension, low blood pressure, alzheimer disease

Enfermedad coronaria en pacientes con psoriasis

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Walter Masson

2013-10-01

Full Text Available Comunicaciones previas asociaron la psoriasis con la enfermedad coronaria. Desconocemos si en nuestro país o región existe dicha asociación. Se realizó un estudio transversal analizando los datos de la historia clínica electrónica de un sistema de salud de Buenos Aires. Analizamos todos los pacientes mayores de 18 años con diagnóstico de psoriasis entre el 1 de enero de 2003 y el 31 de julio de 2011 y los comparamos con un grupo control, en una relación 2:1, obtenido en forma aleatoria del mismo sistema de salud, apareados por edad y sexo. Determinamos la prevalencia de los factores de riesgo cardiovascular y de enfermedad coronaria. Analizamos la asociación entre la enfermedad coronaria y la psoriasis mediante análisis uni y multivariado. Se incluyeron 3 833 sujetos (1 286 pacientes con psoriasis y 2 547 controles. La prevalencia de hipertensión arterial (50% vs. 38%, p < 0.001, tabaquismo (25% vs. 17%, p < 0.001, diabetes (12% vs. 8%, p < 0.001 y enfermedad coronaria (4.98% vs. 3.06%, p = 0.003 fue mayor en los sujetos con psoriasis en comparación con el grupo control. Independientemente de la edad, la presencia de diabetes, hipertensión arterial o tabaquismo, hubo una asociación significativa entre la enfermedad coronaria y la psoriasis (OR 1.48, IC95% 1.04-2.11, p = 0.03. En conclusión, en esta población de Buenos Aires, los pacientes con psoriasis tuvieron una mayor prevalencia de diabetes, hipertensión arterial, tabaquismo y enfermedad coronaria. La asociación entre la psoriasis y la enfermedad coronaria fue independiente de los factores de riesgo explorados.

Enfermedad de Hirschsprung

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K A Santos-Jasso

2017-01-01

Full Text Available El diagnóstico de la enfermedad de Hirschsprung se debe sospechar en el recién nacido que presenta datos de obstrucción intestinal: vómito, distensión abdominal y falla para el paso de meconio, en la primera semana de vida, lo que sustenta su origen congénito. Los pacientes con esta enfermedad son predominantemente del sexo masculino (84%; suelen presentar impactación fecal colónica y en la valoración abdominal muestran desimpactación, que puede ser explosiva en el examen digital del recto con vaciamiento en el 96% de los pacientes.

Current status and outlook of endovascular therapy for cerebral ischemic diseases

International Nuclear Information System (INIS)

Li Minghua; Zhao Jungong

2005-01-01

Improvement of diagnostic technology and increasing advent of new materials for intervention has created a new area for endovascular therapy of cerebral ischemic diseases. Current research findings have shown that endovascular thrombolysis in acute stage of cerebral infarction can accelerate the rate of re-canalization of occluded arteries and greatly decrease the morbidity and mortality of cerebral ischemic vascular diseases. Stenting of arterial stenosis can the improve of blood supply distal to the lesion, prevent recurrent cerebral ischemic stroke. As a result, endovascular thrombolysis for acute cerebral infarction and stenting for intracranial and carotid arterial stenosis are booming both at home and abroad. Proper selection of patients of acute cerebral infarction for endovascular thrombolysis with less complications could be achieved through CT perfusion, MR perfusion-weighted image (PWI) and diffusion-weighted image (DWI), non-invasive vascular imaging technology including CEMRA and CTA for confirming and demonstrating the sites and causes of cerebral ischemia, and furthermore for evaluating the survival ability and etc. The research team administered albumin and magnesium sulfate as neurological protection drug to treat rat infarction model within 6 hours of onset resulting with the same effect of decreasing the damage of ischemic cerebral tissue and without hemorrhagic complication. It is certain that hemorrhagic complication in thrombolysis is a result of multiple factors with no single drug being able to solve the problem. It is predictable that, based on semi-quantitative or quantitative parameters of CT or MRI in conjunction with PWI/DWI mismatch model rather than simply on the onset time of infarction for proper selection of patients of cerebral infarction, mechanic thrombus-disruption and/or intra-arterial thrombolysis together with intervention of neurological protection drug will be the trend for treating acute cerebral infarction in the future

An investigation of cerebral magnetic resonance angiography, 4

International Nuclear Information System (INIS)

Takeda, Sadanori; Sadamoto, Kazuhiko; Ohue, Shiro; Todo, Hirooki; Sakaki, Saburo.

1991-01-01

We have been studying MR angiography using the 0.5 tesla system. Recently we developed three-dimensional MR angiography on the 0.5 tesla system using the gradient-echo technique. The purpose of this study is to evaluate the clinical ability of this newly developed 3-D MR angiography to detect intracranial vascular diseases in comparison with SE or 2-D MR angiography. Twenty-eight patients (15 cerebral aneurysms, 8 arteriovenous malformations, and 5 others) were examined. Three-dimensional MR angiography was performed with TRs of from 60 to 90 msec, TEs of from 16 to 22 msec, flip angls of from 15 to 45 degrees, and a 256x256x16 or 32 matrix. The imaging volumes ranged in thickness from 48 to 64 mm. In our study, a subtraction technique composed of rephased and dephased sequences was applied. As the result of utilizing 0.5 tesla 3-D MR angiography with optimal parameters, good visualization of main cerebral arteries such as second-order branches was obtained. Cerebral aneurysms, AVMs, and arterial occlusions were also well demonstrated, but some of the giant aneurysms were displayed insufficiently for the various flows to be determined. We concluded that 3-D MR angiography on the 0.5 tesla system has the ability to detect intracranial vascular lesions and should be the method for the screening and follow-up of intracranial vascular diseases. (author)

Enfermedad de Chagas o Tripanosomiasis Americana.

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Felipe Guhl

2000-08-01

Full Text Available

Situación Actual de Colombia.

La enfermedad de Chagas o tripanosomiasis americana es una enfermedad parasitaria crónica causada por un protozoario flagelado el Trypanosoma cruzi, descrito por primera vez por Carlos Chagas, médico brasileño, a comienzos de este siglo y en su honor se denominó la enfermedad que lleva su nombre.

Este parásito normalmente se transmite al ser humano a través de insectos triatomíneos estrictamente hematófagos de la familia Reduviidae, en el momento en que perforan la piel para succionar la sangre que los alimenta.

Sin embargo, no se inocula directamente por intermedio de las estructuras bucales del insecto en el momento de la picadura como en el caso de las tripanosomiasis africanas, si no que se deposita pasivamente en la piel a través de las heces del insecto, penetrando en el cuerpo por la herida que causa la picadura u otras abrasiones de la piel o de la mucosa. El T. cruzi, también puede transmitirse por infección congénita, por transfusión de sangre contaminada o por el transplante de órganos contaminados. El ciclo vital del parásito es largo y complejo y su desarrollo tiene varias etapas, tanto en el vector triatomineo como en el huésped vertebrado .

La Enfermedad de Chagas constituye una amenaza permanente para casi la cuarta parte de toda la población de América Latina. Si bien la enfermedad se encuentra presente en toda América Central y del Sur, sus manifestaciones y características epidemiológicas son altamente variables entre una y otra zona endémica. Existe una gran diversidad en las tasas de prevalencia, formas de transmisión, características parasitarias, patología clínica, vectores y reservorios.

Más que cualquier otra enfermedad parasitaria, la enfermedad de Chagas se relaciona con el desarrollo económico y social de la población: los insectos triatomineos y las enfermedades que ellos transmiten existirán mientras en

Statin therapy exacerbates alcohol-induced constriction of cerebral arteries via modulation of ethanol-induced BK channel inhibition in vascular smooth muscle.

Science.gov (United States)

Simakova, Maria N; Bisen, Shivantika; Dopico, Alex M; Bukiya, Anna N

2017-12-01

Statins constitute the most commonly prescribed drugs to decrease cholesterol (CLR). CLR is an important modulator of alcohol-induced cerebral artery constriction (AICAC). Using rats on a high CLR diet (2% CLR) we set to determine whether atorvastatin administration (10mg/kg daily for 18-23weeks) modified AICAC. Middle cerebral arteries were pressurized in vitro at 60mmHg and AICAC was evoked by 50mM ethanol, that is within the range of blood alcohol detected in humans following moderate-to-heavy drinking. AICAC was evident in high CLR+atorvastatin group but not in high CLR diet+placebo. Statin exacerbation of AICAC persisted in de-endothelialized arteries, and was blunted by CLR enrichment in vitro. Fluorescence imaging of filipin-stained arteries showed that atorvastatin decreased vascular smooth muscle (VSM) CLR when compared to placebo, this difference being reduced by CLR enrichment in vitro. Voltage- and calcium-gated potassium channels of large conductance (BK) are known VSM targets of ethanol, with their beta1 subunit being necessary for ethanol-induced channel inhibition and resulting AICAC. Ethanol-induced BK inhibition in excised membrane patches from freshly isolated myocytes was exacerbated in the high CLR diet+atorvastatin group when compared to high CLR diet+placebo. Unexpectedly, atorvastatin decreased the amount and function of BK beta1 subunit as documented by immunofluorescence imaging and functional patch-clamp studies. Atorvastatin exacerbation of ethanol-induced BK inhibition disappeared upon artery CLR enrichment in vitro. Our study demonstrates for the first time statin's ability to exacerbate the vascular effect of a widely consumed drug of abuse, this exacerbation being driven by statin modulation of ethanol-induced BK channel inhibition in the VSM via CLR-mediated mechanism. Copyright © 2017 Elsevier Inc. All rights reserved.

Vascular cognitive impairment

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N.V. Vakhnina

2014-01-01

Full Text Available Vascular pathology of the brain is the second most common cause of cognitive impairment after Alzheimer's disease. The article describes the modern concepts of etiology, pathogenetic mechanisms, clinical features and approaches to diagnosis and therapy of vascular cognitive impairment (VCI. Cerebrovascular accident, chronic cerebral circulatory insufficiency and their combination, sometimes in combination with a concomitant neurodegenerative process, are shown to be the major types of brain lesions leading to VCI. The clinical presentation of VCI is characterized by the neuropsychological status dominated by impairment of the executive frontal functions (planning, control, attention in combination with focal neurological symptoms. The diagnosis is based on comparing of the revealed neuropsychological and neurological features with neuroimaging data. Neurometabolic, acetylcholinergic, glutamatergic, and other vasoactive drugs and non-pharmacological methods are widely used to treat VCI. 

Compromiso vascular en la encefalitis herpética

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Carlos Alberto Cañas

1997-01-01

Full Text Available Describimos el caso de un paciente de 30 años de edad que desarrolla una encefalitis fatal par Herpes simple, en cuyos hallazgos de necropsia se destaca un compromiso vascular cerebral secundario. Se discute In posibilidad de que en la encefalitis herpética pueden presentarse dos tipos de compromiso vascular: uno reconocido desde hace tres décadas, la vasculomielinopatía diseminada, y otro, una forma de vasculitis séptica.

Vascular and hypoxic tissue lesions in cranial computerized tomography and their differential diagnosis

Energy Technology Data Exchange (ETDEWEB)

Kuckein, D

1982-09-01

CT findings and differential diagnosis in cerebral infarctions caused by vascular stenosis or occlusion, by emboli or arterial thrombosis are discussed; also in cerebral and sinus venous thrombosis. Brain damage due to hypoxia, to a combination of hypoxia and sinus venous thrombosis or to one of hypoxia and hyperpyrexia are presented.

Segmentação das áreas isquêmicas no acidente vascular cerebral utilizando imagens de tomografia computadorizada de perfusão

OpenAIRE

Lilian Contin

2011-01-01

As técnicas de processamento digital de imagens têm sido vastamente aplicadas às imagens médicas. Um dos benefícios ocasionado por estas ferramentas é o de prover medidas de parâmetros que são difíceis de estimar e suscetíveis a viés do médico. O presente trabalho teve por objetivo desenvolver um software semi-automático de segmentação das áreas isquêmicas, core e penumbra, no acidente vascular cerebral, utilizando técnicas de segmentação por limiarização e baseada em regiões. Os dois algorit...

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

DEFF Research Database (Denmark)

Vorstrup, S; Hemmingsen, Ralf; Lindewald, H

1982-01-01

Cerebral blood flow CBF was studied in 14 patients with transient ischemic attacks TIA and arteriosclerotic neck vessel disease. CBF was measured by a rapidly rotating single photon emission computerized tomograph using Xenon-133 inhalation. This method yields images of 3 brain slices depicting CBF...... with no abnormality on the CT-scan. The abnormal blood flow pattern was found to be unchanged after clinically successful reconstructive vascular surgery. This suggests the presence of irreversible ischemic tissue damage without gross emollition (incomplete infarction). It is concluded, that TIAs are often harmful...... events, as no less than 9 of the 14 patients studied had evidence of complete and/or incomplete infarction. Thorough examination and rational therapy should be instituted as soon as possible to prevent further ischemic lesions....

Subarachnoid hemorrhage enhances endothelin receptor expression and function in rat cerebral arteries

DEFF Research Database (Denmark)

Hansen-Schwartz, Jacob; Hoel, Natalie Løvland; Zhou, Mingfang

2003-01-01

OBJECTIVE: Inspired by organ culture-induced changes in the vascular endothelin (ET) receptor population, we investigated whether such changes occur in cerebral arteries in a rat subarachnoid hemorrhage (SAH) model. METHODS: SAH was induced with injection of 250 microl of blood into the prechiasm......OBJECTIVE: Inspired by organ culture-induced changes in the vascular endothelin (ET) receptor population, we investigated whether such changes occur in cerebral arteries in a rat subarachnoid hemorrhage (SAH) model. METHODS: SAH was induced with injection of 250 microl of blood...... into the prechiasmatic cistern. After 2 days, the middle cerebral artery, basilar artery, and posterior communicating artery were harvested. Pharmacological studies were performed in vitro, and levels of messenger ribonucleic acid (mRNA) were quantified in real-time reverse transcriptase-polymerase chain reaction assays....... RESULTS: In the middle cerebral artery and basilar artery from rats with induced SAH, enhanced biphasic responses to ET-1 were observed. The -log(50% effective concentration) value for the high-affinity phase was approximately 12, compared with approximately 8.5 for sham-operated animals...

A schizophrenic patient with cerebral infarctions after hemorrhagic shock

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Youichi Yanagawa

2013-01-01

Full Text Available We herein report the fourth case of cerebral infarction, concomitant with hemorrhagic shock, in English literature. A 33-year-old male, who had been diagnosed with schizophrenia and given a prescription for Olanzapine, was discovered with multiple self-inflicted bleeding cuts on his wrist. On arrival, he was in hemorrhagic shock without verbal responsiveness, but his vital signs were normalized following infusion of Lactate Ringer′s solution. The neuroradiological studies revealed multiple cerebral ischemic lesions without any vascular abnormality. He was diagnosed with speech apraxia, motor aphasia, and dysgraphia, due to multiple cerebral infarctions. As there was no obvious causative factor with regard to the occurrence of cerebral infarction in the patient, the hypoperfusion due to hemorrhagic shock, and the thromboembolic tendency due to Olanzapine, might have acted together to lead to the patient′s cerebral ischemia.

Attenuated flow‐induced dilatation of middle cerebral arteries is related to increased vascular oxidative stress in rats on a short‐term high salt diet

Science.gov (United States)

Cosic, Anita; Jukic, Ivana; Stupin, Ana; Mihalj, Martina; Mihaljevic, Zrinka; Novak, Sanja; Vukovic, Rosemary

2016-01-01

Key points Recent studies have shown that high salt (HS) intake leads to endothelial dysfunction and impaired vascular reactivity in different vascular beds in both animal and human models, due to increased oxidative stress.The objective of this study was to assess vascular response to flow‐induced dilatation (FID) and to elucidate the role of vascular oxidative stress/antioxidative capacity in middle cerebral arteries (MCAs) of HS‐fed rats in vitro.The novelty of this study is in demonstrating impaired flow‐induced dilatation of MCAs and down‐regulation of vascular antioxidant genes with HS intake, leading to increased levels of oxidative stress in blood vessels and peripheral lymph organs, which together contribute to impaired FID.In addition, results show increased oxidative stress in leukocytes of peripheral lymph organs, suggesting the occurrence of inflammatory processes due to HS intake.Recirculation of leukocytes might additionally increase vascular oxidative stress in vivo. Abstract The aim of this study was to determine flow‐induced dilatation (FID) and the role of oxidative stress/antioxidative capacity in isolated, pressurized middle cerebral arteries (MCAs) of high salt (HS)‐fed rats. Healthy male Sprague‐Dawley rats (11 weeks old) were fed low salt (0.4% NaCl; LS group) or high salt (4% NaCl; HS group) diets for 1 week. Reactivity of MCAs in response to stepwise increases in pressure gradient (Δ10–Δ100 mmHg) was determined in the absence or presence of the superoxide dismutase (SOD) mimetic TEMPOL and/or the nitric oxide synthases (NOS) inhibitor N ω‐nitro‐l‐arginine methyl ester (l‐name). mRNA levels of antioxidative enzymes, NAPDH‐oxidase components, inducible (iNOS) and endothelial nitric oxide synthases (eNOS) were determined by quantitative real‐time PCR. Blood pressure (BP), antioxidant enzymes activity, oxidative stress in peripheral leukocytes, lipid peroxidation products and the antioxidant capacity of plasma

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

Energy Technology Data Exchange (ETDEWEB)

Kang, Do Young; Park, Kyung Won; Kim, Jae Woo [College of Medicine, Univ. of Donga, Busan (Korea, Republic of)

2003-07-01

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

Enfermedad pulmonar intersticial asociada a rituximab

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Marcelo Fernández Casares

2013-08-01

Full Text Available La introducción en la práctica clínica del anticuerpo anti-CD20 rituximab ha mejorado sustancialmente el pronóstico de diversas enfermedades autoinmunes y hematológicas. Con el incremento de su uso ha aumentado el registro de efectos adversos, entre ellos la toxicidad pulmonar. Una de sus complicaciones más serias es la enfermedad pulmonar intersticial, entidad potencialmente fatal que debe ser considerada en pacientes que han recibido rituximab y presentan disnea, fiebre y tos sin clara evidencia de infección. Presentamos un caso de enfermedad pulmonar intersticial asociada a rituximab.

Vascular hemichorea: case report and review

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Bárbara Martínez Alfonzo

2014-04-01

Full Text Available Chorea rarely complicates ischemic or hemorrhagic cerebral vascular lesions. Clinical symptoms usually involve one side of the body while the injury is situated on the contralateral cerebral hemisphere. Spontaneous remission is the norm, but sometimes symptomatic treatment is required. A 58-year-old male patient who suffers from untreated high blood pressure, type II obesity, smokes 6 packs of cigarettes per year and has a moderate intake of alcohol is presented. The patient’s recent history began three days before he appeared at the Emergency Department. His symptoms were ceaseless, involuntary movements in his left arm and foot during day and night with no restriction of voluntary movements. Physical examination and laboratory tests revealed no other findings. Magnetic resonance imaging of the brain showed hyperintensity in the right posterolateral thalamic region consistent with ischemic cerebrovascular disease. Symptomatic therapy was indicated and his underlying conditions were addressed. The importance of this case lies on the low prevalence as well as the scarcity of publications regarding vascular causes of hemichorea, including diagnosis, therapy and prognosis.

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

Energy Technology Data Exchange (ETDEWEB)

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

2012-04-15

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

Effects of smoking on regional cerebral blood flow in cerebral vascular disease patients and normal subjects

International Nuclear Information System (INIS)

Kubota, Kazuo; Yamaguchi, Tatsuo; Fujiwara, Takehiko; Matsuzawa, Taiju

1987-01-01

The chronic effect of smoking on the regional cerebral blood flow (r-CBF) was studied by 133-Xenon inhalation method and described with the Initial Slope Index (ISI). Fifty-two patients as the control group who had no abnormality neurologically or with CT scan, 32 patients with old cerebral infarction and 20 patients with old cerebral hemorrhage were introduced to the present study, and these patients were divided into smokers and non-smokers in each group. Those whose smoking index of 200 or more [(number of cigarettes/day) x (years of smoking history) ≥ 200] were designated as smokers. ISI values were decreased significantly in smokers than non-smokers in all groups. Mean ISI value of unaffected hemisphere in smokers decreased by 16 % in the infarction group and 22 % in the hemorrhage group comparing to the non-smokers', respectively. In the control group, mean ISI value of right hemisphere decreased by 15 % and left 14 % in smokers compared to the non-smokers. The r-CBF values in 44 of the 47 smokers were found to be lower than the expected age matched values in non-smokers. Serum high density lipoprotein cholesterol value in smokers was significantly lower than that in non-smokers. We demonstrated preliminarily that the smoking chronically reduced the r-CBF. Advanced atherosclerosis associated with the smoker was suggested to affect the CBF. (author)

ACTIVITIES RESULTS AIMED AT IMPROVED MEDICAL ASSISTANCE TO THE VASCULAR PATIENTS IN TOMSK REGION

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D. M. Plotnikov

2013-01-01

Full Text Available Acute disorders of cerebral circulation remain serious medical and social problem associated with high disability and mortality rates. Since 2011 Tomsk oblast is a participating member of the medical campaign aimed at improved medical services to the vascular patients. The preliminary implementation data analysis for 2012 revealed improvement of most of the indices of medical support to patients suffering from acute cerebral circulation; increased number of the in-patient cases (Regional Vascular Center and primary vascular department, decreased lethality rates from strokes, specifically hemorrhagic cases. Strict observance of the Regulations on Medical Assistance for stroke patients and the using of modern methods of therapy allowed to decrease hospital mortality in the Primary Vascular Departments and early mortality in the Regional Vascular Center. The active implementation of neurorehabilitation approaches resulted in the increased number of patients who do not require third parties’ assistance. Analysis of the work of the departments helped to identifying current problems and perspectives of further development of special medical care for stroke patients.

Hemodynamics in the cerebral cortex and basal ganglia

International Nuclear Information System (INIS)

Yamaguchi, Shinya; Fukuyama, Hidenao; Yamauchi, Hiroshi; Kimura, Jun

1991-01-01

We examined ten healthy volunteers using positron emission tomography (PET) in order to elucidate regional changes and correlations in the cerebral circulation and oxygen metabolism. We also studied eight lacunar stroke patients so as to disclose the influences of vascular risk factors and aging on the cerebral blood flow and metabolism. We can conclude from our result as follows: (1) Cerebral blood volume (CBV) was minimum in the basal ganglia and cerebral blood flow (CBF)/CBV ratio was higher than that of cerebral cortex in healthy volunteers; (2) CBF of gray matter in healthy volunteers correlated with CBV and cerebral metabolic rate of oxygen where oxygen extraction fraction inversely correlated with CBF, CBV, and CBF/CBV; and (3) the basal ganglia CBF/CBV ratio in lacunar stroke patients was lower than that of healthy volunteers. These findings suggested that the perfusion pressure in the basal ganglia was so high in the normal condition than the angionecrosis or occlusion in the perforating arteries would be induced, especially in the aged and hypertensive patients. (author)

A model of the instantaneous pressure-velocity relationships of the neonatal cerebral circulation.

Science.gov (United States)

Panerai, R B; Coughtrey, H; Rennie, J M; Evans, D H

1993-11-01

The instantaneous relationship between arterial blood pressure (BP) and cerebral blood flow velocity (CBFV), measured with Doppler ultrasound in the anterior cerebral artery, is represented by a vascular waterfall model comprising vascular resistance, compliance, and critical closing pressure. One min recordings obtained from 61 low birth weight newborns were fitted to the model using a least-squares procedures with correction for the time delay between the BP and CBFV signals. A sensitivity analysis was performed to study the effects of low-pass filtering (LPF), cutoff frequency, and noise on the estimated parameters of the model. Results indicate excellent fitting of the model (F-test, p model parameters have a mean correlation coefficient of 0.94 with the measured flow velocity tracing (N = 232 epochs). The model developed can be useful for interpreting clinical findings and as a framework for research into cerebral autoregulation.

An intelligent support system for automatic detection of cerebral vascular accidents from brain CT images.

Science.gov (United States)

Hajimani, Elmira; Ruano, M G; Ruano, A E

2017-07-01

This paper presents a Radial Basis Functions Neural Network (RBFNN) based detection system, for automatic identification of Cerebral Vascular Accidents (CVA) through analysis of Computed Tomographic (CT) images. For the design of a neural network classifier, a Multi Objective Genetic Algorithm (MOGA) framework is used to determine the architecture of the classifier, its corresponding parameters and input features by maximizing the classification precision, while ensuring generalization. This approach considers a large number of input features, comprising first and second order pixel intensity statistics, as well as symmetry/asymmetry information with respect to the ideal mid-sagittal line. Values of specificity of 98% and sensitivity of 98% were obtained, at pixel level, by an ensemble of non-dominated models generated by MOGA, in a set of 150 CT slices (1,867,602pixels), marked by a NeuroRadiologist. This approach also compares favorably at a lesion level with three other published solutions, in terms of specificity (86% compared with 84%), degree of coincidence of marked lesions (89% compared with 77%) and classification accuracy rate (96% compared with 88%). Copyright © 2017. Published by Elsevier B.V.

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

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Fernando Madalena Volpe

1999-09-01

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

Microparticle Shedding from Neural Progenitor Cells and Vascular Compartment Cells Is Increased in Ischemic Stroke.

Science.gov (United States)

Chiva-Blanch, Gemma; Suades, Rosa; Crespo, Javier; Peña, Esther; Padró, Teresa; Jiménez-Xarrié, Elena; Martí-Fàbregas, Joan; Badimon, Lina

2016-01-01

Ischemic stroke has shown to induce platelet and endothelial microparticle shedding, but whether stroke induces microparticle shedding from additional blood and vascular compartment cells is unclear. Neural precursor cells have been shown to replace dying neurons at sites of brain injury; however, if neural precursor cell activation is associated to microparticle shedding, and whether this activation is maintained at long term and associates to stroke type and severity remains unknown. We analyzed neural precursor cells and blood and vascular compartment cells microparticle shedding after an acute ischemic stroke. Forty-four patients were included in the study within the first 48h after the onset of stroke. The cerebral lesion size was evaluated at 3-7 days of the stroke. Circulating microparticles from neural precursor cells and blood and vascular compartment cells (platelets, endothelial cells, erythrocytes, leukocytes, lymphocytes, monocytes and smooth muscle cells) were analyzed by flow cytometry at the onset of stroke and at 7 and 90 days. Forty-four age-matched high cardiovascular risk subjects without documented vascular disease were used as controls. Compared to high cardiovascular risk controls, patients showed higher number of neural precursor cell- and all blood and vascular compartment cell-derived microparticles at the onset of stroke, and after 7 and 90 days. At 90 days, neural precursor cell-derived microparticles decreased and smooth muscle cell-derived microparticles increased compared to levels at the onset of stroke, but only in those patients with the highest stroke-induced cerebral lesions. Stroke increases blood and vascular compartment cell and neural precursor cell microparticle shedding, an effect that is chronically maintained up to 90 days after the ischemic event. These results show that stroke induces a generalized blood and vascular cell activation and the initiation of neuronal cell repair process after stroke. Larger cerebral lesions

Microparticle Shedding from Neural Progenitor Cells and Vascular Compartment Cells Is Increased in Ischemic Stroke.

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Gemma Chiva-Blanch

Full Text Available Ischemic stroke has shown to induce platelet and endothelial microparticle shedding, but whether stroke induces microparticle shedding from additional blood and vascular compartment cells is unclear. Neural precursor cells have been shown to replace dying neurons at sites of brain injury; however, if neural precursor cell activation is associated to microparticle shedding, and whether this activation is maintained at long term and associates to stroke type and severity remains unknown. We analyzed neural precursor cells and blood and vascular compartment cells microparticle shedding after an acute ischemic stroke.Forty-four patients were included in the study within the first 48h after the onset of stroke. The cerebral lesion size was evaluated at 3-7 days of the stroke. Circulating microparticles from neural precursor cells and blood and vascular compartment cells (platelets, endothelial cells, erythrocytes, leukocytes, lymphocytes, monocytes and smooth muscle cells were analyzed by flow cytometry at the onset of stroke and at 7 and 90 days. Forty-four age-matched high cardiovascular risk subjects without documented vascular disease were used as controls.Compared to high cardiovascular risk controls, patients showed higher number of neural precursor cell- and all blood and vascular compartment cell-derived microparticles at the onset of stroke, and after 7 and 90 days. At 90 days, neural precursor cell-derived microparticles decreased and smooth muscle cell-derived microparticles increased compared to levels at the onset of stroke, but only in those patients with the highest stroke-induced cerebral lesions.Stroke increases blood and vascular compartment cell and neural precursor cell microparticle shedding, an effect that is chronically maintained up to 90 days after the ischemic event. These results show that stroke induces a generalized blood and vascular cell activation and the initiation of neuronal cell repair process after stroke. Larger

Cerebral angiographic findings in thromboangiitis obliterans

International Nuclear Information System (INIS)

No, Young J.; Lee, Eun M.; Kim, Jong S.; Lee, Deok H.

2005-01-01

Transient ischemic attacks (TIAs) or ischemic stroke may complicate thromboangiitis obliterans (TAO). However, there has been debate regarding the mechanism of ischemic stroke in TAO. We report the case of a patient with TAO who developed repeated TIAs. An angiogram showed multiple alternative areas of arterial occlusions in the distal segments of both middle cerebral arteries. Extensive collateral vessels around the occluded segment were also observed, which resembled the ''tree root'' or ''corkscrew'' vessels described in the peripheral arteries in TAO. Our patient illustrates that cerebral manifestations of TAO may occur with vascular changes that are identical with those encountered in the limb arteries in TAO. (orig.)

Hereditary cerebral hemorrhage with amyloidosis in patients of Dutch origin is related to Alzheimer disease

International Nuclear Information System (INIS)

van Duinen, S.G.; Castano, E.M.; Prelli, F.; Bots, G.T.A.B.; Luyendijk, W.; Frangione, B.

1987-01-01

Hereditary cerebral hemorrhage with amyloidosis in Dutch patients is an autosomal dominant form of vascular amyloidosis restricted to the leptomeninges and cerebral cortex. Clinically the disease is characterized by cerebral hemorrhages leading to an early death. Immunohistochemical studies of five patients revealed that the vascular amyloid deposits reacted intensely with an antiserum raised against a synthetic peptide homologous to the Alzheimer disease-related β-protein. Silver stain-positive, senile plaque-like structures were also labeled by the antiserum, yet these lesions lacked the dense amyloid cores present in typical plaques of Alzheimer disease. No neurofibrillary tangles were present. Amyloid fibrils were purified from the leptomeningeal vessels of one patient who clinically had no signs of dementia. The protein had a molecular weight of ∼ 4000 and its partial amino acid sequence to position 21 showed homology to the β-protein of Alzheimer disease and Down syndrome. These results suggest that hereditary cerebral hemorrhage with amyloidosis of Dutch origin is pathogenetically related to Alzheimer disease and support the concept that the initial amyloid deposition in this disorder occurs in the vessel walls before damaging the brain parenchyma. Thus, deposition of β-protein in brain tissue seems to be related to a spectrum of diseases involving vascular syndromes, progressive dementia, or both

¿Qué es una enfermedad rara?

OpenAIRE

Dirección General de Salud Pública y Participación. Gobierno del Principado de Asturias

2014-01-01

Enfermedades Raras en Asturias. Dirección General de Salud Pública y Participación. Informes breves 01 Defining what is meant by rare diseases. Definición de lo que se entiende por enfermedades raras.

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

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Hyoung Kyu Kim

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

Endovascular treatment of cerebral aneurysms at Altai Regional Vascular Center

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Д. А. Долженко

2015-10-01

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

Enfermedad de Chagas en Colombia

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Fernando Serpa Florez

1985-12-01

Full Text Available

Generalidades.

La tripanosomiasis americana o enfermedad de Chagas se halla ampliamente distribuida en Centro y Sur América. La Organización Mundial de la Salud considera que pueden haber doce millones de casos de esta dolencia en el continente (1, estudiados principalmente en Argentina, Brasil y Venezuela. Se calcula que en Colombia tendríamos una incidencia muy alta de casos, (Marinkelle (2 estima que 7.140/0 de la población podría estar infectada o sea cerca de dos millones de personas, distribuidos en las zonas rurales del nordeste del país (cuenca del Catatumbo Magdalena Medio y Llanos Orientales (Piedemonte, Macarena y Meta cercano (3 (4 (5 Y que seis millones de nuestros compatriotas -22.30/0 de la población total- (2 corren el riesgo de adquirir la enfermedad pues habitan en regiones donde se dan las condiciones para que ésta se propague.

RESEÑA HISTORICA DE LA ENFERMEDAD EN COLOMBIA
La existencia de casos de tripanosomiasis americana y de sus vectores fue comprobada en Colombia desde 1929 cuando César Uribe Piedrahita (6 encontró en Prado, Tolima, vectores del mal infectados con T.

cruzi e Ignacio Moreno Pérez observó dicho hemoflagelado en sangre de seres humanos en Cali (4. En los años siguientes Hernando Ucrós, Benjamín Otálora, Hernando Groot, Santiago Renjifo, Hernando Osorno, Carlos Duarte Rangel, C.J. Marinkelle, Augusto Corredor, Ernesto Suescún y varios otros investigadores colomb iano s describieron diversos focos de la enfermedad en Colombia y estudiaron la distribución de sus vectores y huéspedes intermediarios. En 1947 1. Caicedo y C. Hernández publicaron su informe sobre los primeros casos crónicos de enfermedad de Chagas comprobados en nuestro país, procedentes de la región de Fusagasugá, Cundinamarca (7 en tanto que, en 1961, Marcos Duque inicia los estudios sobre cardiopatía chagásica (8 y Hernando Rocha, en 1971, comunica

ACTUALIZACIÓN EN LA ENFERMEDAD DE PARKINSON

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Dr. Raúl Martínez-Fernández.

2016-05-01

Full Text Available La enfermedad de Parkinson es un trastorno neurodegenerativo complejo y de presentación heterogénea. Aunque aún no se dispone de ningún fármaco que enlentezca la progresión de la enfermedad, existe un arsenal terapéutico extenso y eficaz para el control sintomático en cada una de sus fases, por lo que es importante realizar un diagnóstico preciso así como un correcto manejo de fármacos que garantice un estado óptimo en los paciente que la sufren, lo que resultará en una mejora en su calidad de vida. Además, dado que es el trastorno neurodegenerativo más frecuente tras la enfermedad de Alzheimer y que su factor de riesgo principal es la edad, la enfermedad de Parkinson supone, cada vez más, un reto de salud pública en nuestras sociedades occidentales progresivamente envejecidas. Esta revisión pretende actualizar los aspectos clínicos y diagnósticos fundamentales de la enfermedad de Parkinson así como las principales estrategias terapéuticas disponibles.

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

DEFF Research Database (Denmark)

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

2015-01-01

Brain activation reduces balance between cerebral consumption of oxygen versus carbohydrate as expressed by the so-called cerebral oxygen-carbohydrate-index (OCI). We evaluated whether preparation for surgery, anaesthesia including tracheal intubation and surgery affect OCI. In patients undergoing...... aortic surgery, arterial to internal jugular venous (a-v) concentration differences for oxygen versus lactate and glucose were determined from before anaesthesia to when the patient left the recovery room. Intravenous anaesthesia was supplemented with thoracic epidural anaesthesia for open aortic surgery...

Response of local vascular volumes to lower body negative pressure stress

Science.gov (United States)

Wolthuis, R. A.; Leblanc, A.; Carpentier, W. A.; Bergman, S. A., Jr.

1975-01-01

The present study involved an intravenous injection of radioactive iodinated serum albumin, equilibration of this isotope within the vascular space, and the continuous measurement of isotope activity over selected anatomical areas before, during and following multiple human LBNP tests. Both rate and magnitude of vascular pooling were distinctly different within each of five selected lower body anatomical areas. In the upper body, all areas except the abdomen showed depletions from their resting vascular volumes during LBNP. The presence of uniquely different pooling patterns in the lower body, the apparent stability of abdominal vascular volumes, and a possible decrease in cerebral blood volume during LBNP represent the major findings of this study.

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

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Ana Amália Torres Souza Gandour Dantas

2014-07-01

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

Angiografía cerebral y muerte encefálica

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Angel J Lacerda Gallardo

1997-08-01

Full Text Available Este trabajo se realizó como parte de un protocolo de estudio, el cual fue aplicado a 57 pacientes atendidos por el servicio de Neurocirugía del Hospital Clinicoquirúrgico "Manuel Ascunce Domenech" de Camagüey, durante el período comprendido entre enero de 1993 y diciembre de 1994. Se realizaron estudios angiográficos a 50 pacientes (87,72 %, de los que se obtuvieron 55 angiogramas cerebrales. En 49 exámenes (89 %, se observó ausencia de flujo sanguíneo cerebral con distintos tipos de patrones vasculares, en la arteria carótida interna extra e intracraneal, lo cual confirma su utilidad en el diagnóstico de la muerte encefálica (ME. En 3 pacientes, con craniectomías osteoclásticas de más de 5 cm, no se demostró ausencia de flujo sanguíneo cerebral, a pesar del estado clínico de ME. No aparecieron complicaciones durante este proceder, gracias a la cuidadosa técnica utilizada. Los patrones vasculares demostrados sugieren realizar un estudio más detallado donde se compare esta imagen con el parámetro presión intracraneal (PIC elevadaThis work was carried out as a part of a study protocol which was applied to 57 patients treated at the Neurosurgical Servicie of "Manuel Ascunce Domenech" Clinicosurgical Hospital, Camagüey during January, 1993 and December, 1994. Angiographic studies were performed to 50 patients (87.72 % from which 55 cerebral angiograms were obtained. In 49 examinations (89 % absenece of brain blood flow was observed with different types of vascular patterns in the extra and intracraneal inner carotid artery proving its usefulness for the diagnosis of brain death. In 3 patients with osteoclastic cranioctomies greater than 5 cm, the absence of cerebral blood flow was not proved despite the clinical status of brain death. No complications were observed during the procedure thanks to the so careful technique that was used. Vascular patterns evidenced suggest that it is necessary to perform a more detailed study to

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

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Jianhong Ye

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

Subjetividad e interseccionalidad: experiencias de Enfermedad de Mujeres Negras con enfermedad falciforme

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Eliana Costa Xavie

2017-05-01

Full Text Available El estudio tuvo el objetivo de conocer y analizar la historia de mujeres negras con enfermedad falciforme y comprender cómo la subjetividad de estas es construida y confrontada a partir de los sentidos subjetivos asociados con los marcadores de género, raza y clase social. Se trata de una investigación cualitativa en la que participaron 9 mujeres negras acompañadas por el Centro de Referencia de la Anemia Falciforme del Hospital de Clínicas de Porto Alegre. Las entrevistas semiestructuradas fueron analizadas por medio del análisis crítico del discurso. Los resultados mostraron que las mujeres negras perciben su enfermedad como condición de salud que estrecha los lazos entre su pertenencia racial y sus construcciones de género y de clase. El discurso de esas mujeres negras trascendió a la complejidad de la enfermedad crónica, transformándola y construyendo posibilidades que las potencializan como mujeres, madres y sujetos sociales. Las mujeres señalaron que la interseccionalidad de raza, género y clase social impulsa la ceguera pública de la mujer negra y de las cuestiones relacionadas con la población negra intensificando el sentimiento de invisibilidad.

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

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Piper, Vanessa Alves

2012-01-01

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

139. Complicaciones Neurológicas Mayores en Octogenarios Tras Cirugía Cardíaca: ¿Es la Edad un Factor Limitante?

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G. Laguna

2012-04-01

Conclusiones: la incidencia de complicación neurológica mayor no es significativamente superior en nuestra población de octogenarios. Mientras en menores de 80 años la existencia de enfermedad vascular es el principal factor determinante, la inadecuada oxigenación cerebral, derivada de situaciones de anemia preoperatoria, parece influir más en la presencia de complicaciones neurológicas en los mayores de 80 años.

Multiple Spontaneous Cerebral Microbleeds and Leukoencephalopathy in PSEN1-Associated Familial Alzheimer's Disease: Mirror of Cerebral Amyloid Angiopathy?

Science.gov (United States)

Floris, Gianluca; Di Stefano, Francesca; Cherchi, Maria Valeria; Costa, Gianna; Marrosu, Francesco; Marrosu, Maria Giovanna

2015-01-01

Cerebral microbleeds (CMB) might reflect specific underlying vascular pathologies like cerebral amyloid angiopathy (CAA). In the present study we report the gradient-echo MRI pattern of two siblings with P284S PSEN1 mutation. T2* gradient-echo images of the two subjects demonstrated multiple microbleeds in lobar regions. The role and causes of CMB in sporadic Alzheimer's disease (AD) patients have not been clearly established and useful contributions could derive from familial AD studies. Furthermore, since CAA is a potential risk factor for developing adverse events in AD immunization trials, the identification in vivo of CAA through non-invasive MRI methods could be useful to monitoring side effects.

Arterial spasm as a finding intimately associated with the onset of vascular headache

International Nuclear Information System (INIS)

Garnic, J.D.; Schellinger, D.

1983-01-01

A patient with migraine headaches of the ''cluster'' variant type is presented in whom vasospasm of the middle cerebral artery, the anterior cerebral artery and the internal carotid artery triggered a pain episode identical in character and severity to the headaches which had led to his investigation. Vasospasm associated with the painful phase of headache in this case conflicts with the more accepted theory that the pain phase of a vascular headache is related to vasodilatation of cerebral or extracerebral vessels. The literature is reviewed. (orig.)

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

International Nuclear Information System (INIS)

Grasset, Gilles.

1975-01-01

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

Enfermedad óseo mineral relacionada con la enfermedad renal crónica: Klotho y FGF23; implicaciones cardiovasculares

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Laura Salanova Villanueva

2016-07-01

Full Text Available Una de las principales causas de morbimortalidad en el paciente con enfermedad renal crónica es la cardiovascular. La inflamación y las alteraciones en el metabolismo óseo mineral son una condición patológica que conlleva aumento del riesgo cardiovascular en la enfermedad renal crónica. Los parámetros bioquímicos clásicos del metabolismo óseo mineral como fósforo, calcio, vitamina D y PTH tienen una implicación muy conocida en el riesgo cardiovascular. Los nuevos marcadores, FGF23 y klotho, también podrían estar implicados en la enfermedad cardiovascular.

Regional cerebral blood flow levels as measured by xenon-CT in vascular territorial low-density areas after subarachnoid hemorrhage are not always ischemic

International Nuclear Information System (INIS)

Fainardi, E.; Tagliaferri, M.F.; Compagnone, C.; Tanfani, A.; Cocciolo, F.; Targa, L.; Chieregato, A.; Battaglia, R.; Frattarelli, M.; Pascarella, R.

2006-01-01

The aim of this study was to assess regional cerebral blood flow (rCBV) in areas of CT hypoattenuation appearing in the postoperative period in patients treated for aneurysmal subarachnoid hemorrhage (SAH) using xenon-enhanced CT scanning (Xe-CT). We analyzed 15 patients (5 male and 10 female; mean age 49.7±12.1 years) with SAH on CT performed on admission to hospital and who showed a low-density area within a well-defined vascular territory on CT scans after clipping or coiling of a saccular aneurysm. All zones of hypoattenuation were larger than 1 cm 2 and showed signs of a mass effect suggesting a subacute phase of evolution. Two aneurysms were detected in two patients. Aneurysms were located in the middle cerebral artery (n=7), in the anterior communicating artery (n=6), in the internal carotid artery (n=3), and in the posterior communicating artery (n=1). Treatments were surgical (n=8), endovascular (n=2) or both (n=1). A total of 36 Xe-CT studies were performed and rCBF values were measured in two different regions of interest (ROI): the low-density area, and an area of normal-appearing brain tissue located symmetrically in the contralateral hemisphere. rCBF levels were significantly lower in the low-density area than in the contralateral normal-appearing area (P 55 ml/100 g per minute) in 2/36 lesions (5.6%). Our study confirmed that rCBF is reduced in new low-density lesions related to specific vascular territories. However, only about one-third of the lesions showed rCBF levels consistent with irreversible ischemia and in a relatively high proportion of lesions, rCBF levels indicated penumbral, oligemic and hyperemic areas. (orig.)

A Means for the Scintigraphic Imaging of Regional Brain Dynamics. Regional Cerebral Blood Flow and Regional Cerebral Blood Volume

Energy Technology Data Exchange (ETDEWEB)

Potchen, E. J.; Bentley, R.; Gerth, W.; Hill, R. L.; Davis, D. O. [Washington University School Of Medicine, St. Louis, MO (United States)

1969-05-15

The use of freely diffusable inert radioactive gas as a washout indicator to measure regional cerebral blood flow has become a standardized kinetic procedure in many laboratories. Recent investigations with this technique have led us to conclude that we can reliably distinguish regional flow with perfusion against regional flow without perfusion from the early portion of the curve. Based on a detailed study of the early curve kinetics in patients with and without cerebral vascular disease we have defined the sampling duration necessary for application of the Anger gamma camera imaging process to regional changes in cerebral radioactivity. Using a standard camera and a small computer, a procedure has been developed and based upon entire field to determine the time of maximum height followed by analysis of the data in a matrix. This will permit a contour plot presentation of calculated regional cerebral blood flow in millilitres per 100 grams perfused brain per minute. In addition, we propose to augment this data by the display of regional non-perfusion blood flow versus regional cerebral flow with perfusion. Preliminary investigation on sampling duration, and Compton scattering were prerequisite to clinical scintigraphy of regional cerebral blood flow. In addition, the method of interface for the conventional Anger gamma camera to digital computers used in this procedure are discussed. Applications to further assess regional cerebral dynamics by scintigraphy are presented. (author)

Intervenção fonoaudiológica e fisioterapêutica em uma mulher após acidente vascular cerebral isquêmico = Speech therapy and physiotherapy intervention in a woman after ischemic stroke

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Rosa, Tábada Samantha Marques

2015-01-01

Full Text Available Objetivos: Relatar um caso em que houve intervenção conjunta entre fonoaudiólogo e fisioterapeuta na reabilitação de uma paciente com acidente vascular cerebral isquêmico. Descrição do caso: Paciente de 48 anos de idade, sexo feminino, acometida por acidente vascular cerebral do tipo isquêmico, há sete meses. Apresentou-se com disartrofonia e alterações do sistema estomatognático e sua funcionalidade, comprometimento sensorial, parestesia da mão direita, diminuição da coordenação motora grossa e fina em ambos os membros superiores, dificuldade na preensão palmar e fraqueza da musculatura intrínseca da mão direita, diminuição da consciência corporal e da propriocepção. Foi submetida a 12 sessões com a periodicidade de uma vez por semana de tratamento fonoterápico e fisioterapêutico. Após as intervenções a paciente apresentou aumento dos tempos máximos de fonação; melhora da coordenação pneumofonoarticulatória, da qualidade vocal e do foco de ressonância vertical; adequação e modulação da loudness; modulação do pitch; melhora da coordenação motora grossa e fina, da sensibilidade tátil e dolorosa, da oposição dos dedos, da preensão palmar, da consciência corporal, da propriocepção e da postura corporal global; e aumento da força muscular dos membros superiores. Conclusões: A intervenção interdisciplinar da fonoaudiologia e fisioterapia proporcionou benefícios à paciente acometida por acidente vascular cerebral isquêmico, sendo que a mesma voltou a exercer sua atividade profissional e suas atividades de vida diária com efetividade e melhorou a comunicação com seus familiares

Transcranial Doppler for detection of cerebral ischaemia during carotid endarterectomy

DEFF Research Database (Denmark)

Jørgensen, L G; Schroeder, T V

1992-01-01

We evaluated transcranial Doppler sonography (TCD) for the detection of cerebral ischaemia during carotid endarterectomy in 30 male and 14 female patients with ipsilateral focal cerebro-vascular symptoms. Surgery was performed during halothane-nitrous oxide anaesthesia with moderate hypocapnia...

Time Course of Changes in Extravascular Lung Water Index, Intracranial and Cerebral Perfusion Pressures in Acute Cerebral Circulatory Disorders

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Yu. A. Churlyaev

2009-01-01

Full Text Available Objective: to study the time course of changes in extravascular lung water index (ELWI and intracranial and cerebral perfusion pressures (ICP and CPP and to determine their possible relationships in acute cerebral circulatory disorders (ACCD. Subject and methods. ELWI, pulmonary vascular permeability index (PVPI, ICP, CPP, and central hemodynamics were studied by transpulmonary thermodilution and current X-ray studies were conducted in 18 patients on days 1, 3, 5, and 7 of ACCD. Results. Examinations revealed a supratentorial dislocation of the brain in 6 persons; its subtento-rial dislocation was found in 1 case; supra- and subtentorial dislocations were seen in 6. In patients, ELWI and PVPI increased from days 1 and 5, respectively. The high baseline ICP increased over time. CPP remained unchanged. Preserved left ventricular contractility, enhanced myocardial one, a significant direct correlation between ELWI and PVPI, as well as their increase confirmed that the noncardiogenic genesis was responsible for increased ELWI. A direct significant correlation was found between ICP and ELWI, ICP and PVPI. Against this background, acute respiratory distress syndrome developed in 14 patients with pneumonia evolving in its presence in 7 patients. Conclusion. In ACCD, ELWI increases in the first 24 hours of the acute period. One of its causes is, along with others, primary and/or secondary damage to the brainstem structures with elevated ICP and progressive brain dislocation. The determination of ICP, unlike CPP, is crucial in the diagnosis and treatment of primary/secondary brain injuries and in prognosis. Key words: acute cerebral circulatory disorder, extravascular lung fluid, pulmonary vascular permeability, intracranial pressure, cerebral perfusion pressure, acute respiratory distress syndrome.

Cerebral Perfusion Enhancing Interventions: A New Strategy for the Prevention of Alzheimer Dementia.

Science.gov (United States)

de la Torre, Jack C

2016-09-01

Cardiovascular and cerebrovascular diseases are major risk factors in the development of cognitive impairment and Alzheimer's disease (AD). These cardio-cerebral disorders promote a variety of vascular risk factors which in the presence of advancing age are prone to markedly reduce cerebral perfusion and create a neuronal energy crisis. Long-term hypoperfusion of the brain evolves mainly from cardiac structural pathology and brain vascular insufficiency. Brain hypoperfusion in the elderly is strongly associated with the development of mild cognitive impairment (MCI) and both conditions are presumed to be precursors of Alzheimer dementia. A therapeutic target to prevent or treat MCI and consequently reduce the incidence of AD aims to elevate cerebral perfusion using novel pharmacological agents. As reviewed here, the experimental pharmaca include the use of Rho kinase inhibitors, neurometabolic energy boosters, sirtuins and vascular growth factors. In addition, a compelling new technique in laser medicine called photobiomodulation is reviewed. Photobiomodulation is based on the use of low level laser therapy to stimulate mitochondrial energy production non-invasively in nerve cells. The use of novel pharmaca and photobiomodulation may become important tools in the treatment or prevention of cognitive decline that can lead to dementia. © 2016 International Society of Neuropathology.

Anatomic vascular phantom for the verification of MRA and XRA visualization and fusion

International Nuclear Information System (INIS)

Mankovich, N.J.; Lambert, T.; Zrimec, T.; Hiller, J.

1995-01-01

A project is underway to develop automated methods of fusing cerebral magnetic resonance angiography (MRA) and x-ray angiography (XRA) for creating accurate visualizations used in planning treatment of vascular disease. The authors have developed a vascular phantom suitable for testing segmentation and fusion algorithms with either derived images (pseudo-MRA/pseudo-XRA) or actual MRA or XRA image sequences. The initial unilateral arterial phantom design, based on normal human anatomy, contains 48 tapering vascular segments with lumen diameters from 2.5 millimeter to 0.25 millimeter. The initial phantom used rapid prototyping technology (stereolithography) with a 0.9 millimeter vessel wall fabricated in an ultraviolet-cured plastic. The model fabrication resulted in a hollow vessel model comprising the internal carotid artery, the ophthalmic artery, and the proximal segments of the anterior, middle, and posterior cerebral arteries. The complete model was fabricated but the model's lumen could not be cleared for vessels with less than 1 millimeter diameter. Measurements of selected vascular outer diameters as judged against the CAD specification showed an accuracy of 0.14 mm and precision (standard deviation) of 0.15 mm. The plastic vascular model produced provides a fixed geometric framework for the evaluation of imaging protocols and the development of algorithms for both segmentation and fusion

Comparison of acetazolamide-enhanced brain SPECT using Tc-99m ECD with cerebral angiography in patients with cerebrovascular disease

International Nuclear Information System (INIS)

Choi, Y. Y.; Moon, D. H.; Ryu, J. S.; Yang, S. H.; Lee, H. K.; Lee, J. H.; Kim, J. S.; Kim, K. A.

1997-01-01

Cerebral vascular reserve can be assessed by development of collateral channels (DCC) on cerebral angiography(CA) or vasoreactivity (VR) on acetazolamide-enhanced brain SPECT (ACZ-SPECT). The purpose of this study was to compare Tc-99m ECD ACZ-SPECT with CA in the evaluation of vascular reserve in patients (pts) with cerebrovascular disease(CVD). Twenty seven patients with CVD, including TIA (n=13), infarction (n=11) and asymptomatic pts (AS, n=3), underwent CA and ACZ-SPECT. Basal and ACZ-SPECT was obtained consecutively, and image subtraction was performed. On CA, degree of DCC was scored 0-3 (0: normal, 3: poor) according to parenchymal staining on delayed film. In ACZ-SPECT, decrease of VR was graded 0-3 (0: normal, 3: more than 30% decrease). The correlation between degree of stenosis, DCC and VR were analyzed. 1) Variable degree of VR or DCC was observed in totally occluded or stenotic cerebral arterial territories. 2) In arterial territories with poor DCC, ACZ-SPECT showed poor VR. However, in 5 out of 11 TIA or AS with good DCC, poor VR was observed. These data suggests that 1) cerebral hemodynamic status cannot be assessed by the degree of stenosis on CA alone. 2) DCC may overestimate the cerebral vascular reserve in patients with TIA or AS. 3) ACZ-SPECT plays a complementary role to CA for evaluation of cerebral hemodynamic status in pts with CVD

Arterial spasm as a finding intimately associated with the onset of vascular headache

Energy Technology Data Exchange (ETDEWEB)

Garnic, J.D.; Schellinger, D.

1983-03-01

A patient with migraine headaches of the ''cluster'' variant type is presented in whom vasospasm of the middle cerebral artery, the anterior cerebral artery and the internal carotid artery triggered a pain episode identical in character and severity to the headaches which had led to his investigation. Vasospasm associated with the painful phase of headache in this case conflicts with the more accepted theory that the pain phase of a vascular headache is related to vasodilatation of cerebral or extracerebral vessels. The literature is reviewed.

Comprehensive Overview of Contemporary Management Strategies for Cerebral Aneurysms.

Science.gov (United States)

Manhas, Amitoz; Nimjee, Shahid M; Agrawal, Abhishek; Zhang, Jonathan; Diaz, Orlando; Zomorodi, Ali R; Smith, Tony; Powers, Ciarán J; Sauvageau, Eric; Klucznik, Richard P; Ferrell, Andrew; Golshani, Kiarash; Stieg, Philip E; Britz, Gavin W

2015-10-01

Aneurysmal subarachnoid hemorrhage (SAH) remains an important health issue in the United States. Despite recent improvements in the diagnosis and treatment of cerebral aneurysms, the mortality rate following aneurysm rupture. In those patients who survive, up to 50% are left severely disabled. The goal of preventing the hemorrhage or re-hemorrhage can only be achieved by successfully excluding the aneurysm from the circulation. This article is a comprehensive review by contemporary vascular neurosurgeons and interventional neuroradiolgists on the modern management of cerebral aneurysms. Copyright © 2015 Elsevier Inc. All rights reserved.

Frequency of cerebral infarction secondary to head injury and the underlying mechanisms: CT study

International Nuclear Information System (INIS)

Fernande-Fresno, L.; Manzanares, R.; Caniego, J.L.; Velasco, M.; Parra, M.L.; Monasterio, F.

1997-01-01

To study the frequency of and possible mechanisms producing severe head injury (HI) by serial CT studies. We reviewed brain CT results in 154 HI patients examined over the past 31 months. All of them were hospitalized in the Intensive Care Unit (ICU) presenting coma with Glosgow Coma Scale scores of 9 or under. A first CT scan was performed when the patients arrived in the emergency room and at a least one more was carried out over the following 1 to 6 days. Sixteen of the 154 patients presented ischemic areas of low attenuation in a territory of defined vascular distribution that did not exist in the CT done at admission; the majority of them also had extensive extraaxial or intraaxial hematomas causing a considerable mass effect and cerebral displacement inducing different types of herniation. The vascular territories involved were anterior cerebral artery in five cases, middle cerebral artery in two, posterior cerebral artery in seven lenticulostriate arteries in six, anterior choroidal artery in five, perforating thalamus in six, recurrent artery in one case and superior cerebellar artery in another. In our series, there was a high prevalence (10.4%) of infarcts associated with severe HI; the most common etiopathogenic mechanisms are cerebral displacement accompanied by compression and vessel strain. (Author) 13 refs

MTHFR and ACE Gene Polymorphisms and Risk of Vascular and Degenerative Dementias in the Elderly

Science.gov (United States)

Pandey, Pratima; Pradhan, Sunil; Modi, Dinesh Raj; Mittal, Balraj

2009-01-01

Focal lacunar infarctions due to cerebral small vessel atherosclerosis or single/multiple large cortical infarcts lead to vascular dementia, and different genes and environmental factors have been implicated in causation or aggravation of the disease. Previous reports suggest that some of the risk factors may be common to both vascular as well as…

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

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André P.C. Matta

2006-06-01

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

[Cerebral protection].

Science.gov (United States)

Cattaneo, A D

1993-09-01

metabolic standpoint, exposure to isoflurane at concentration of 2 MAC is credited with providing the same potential for protection as high dose barbiturate (isoelectric EEG). A possible major difference between barbiturates and isoflurane is the modest cerebral vasodilation induced by the latter while barbiturates are associated with decreased CBF. This suggests that in focal ischemia isoflurane may elicit an intracerebral steal. 3) Calcium entry blockers. Some calcium entry blockers with the distinctive feature of acting preferably on cerebral as opposed to systemic vascular smooth muscles may exert beneficial effects during or after brain ischemia. Two such drugs which have shown promise are nimodipine and lidoflazine. In animal and human studies nimodipine has been reported to improve the neurologic outcome of both the cerebral vasospasm and the postischemic hypoperfusion state.(ABSTRACT TRUNCATED AT 400 WORDS)

a enfermedades laborales en España, 2004

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Ana M. García García

2007-01-01

Full Text Available Fundamento: El registro de enfermedades profesionales en España resulta insuficiente para valorar el impacto de las enfermedades de origen laboral en nuestro país. En el presente estudio se estima la mortalidad por enfermedades laborales y sus costes en base a riesgos atribuibles estimados en la literatura internacional. Métodos: Se aplican estimaciones de riesgo atribuible para la mortalidad de origen laboral calculadas por Nurminen y Karjalainen (Finlandia, 2001 al total de muertes por las enfermedades y grupos de edad relevantes en España y por comunidades autónomas en 2004. Se calculan los años potenciales de vida y de vida laboral perdidos. A partir de estos últimos, se estiman los costes actualizados de la pérdida de vida productiva debida a las muertes por enfermedades laborales en España. Resultados: Según nuestras estimaciones, en 2004 se habrían producido en España cerca de 16.000 muertes por enfermedades relacionadas con exposiciones laborales, la mayoría en hombres (87%. Estas muertes habrían causado cerca de 152.000 años potenciales de vida perdidos y algo más de 47.000 años potenciales de vida laboral perdidos, lo que conllevaría un coste actualizado en pérdidas de productividad entre 580 y 1.000 millones de euros. Conclusiones: En 2004 el registro de enfermedades profesionales en España sólo recogió dos muertes por esta causa. Sin embargo, los resultados del presente estudio ponen de manifiesto la importancia de las condiciones de trabajo como determinantes de muertes evitables en la población y la inminente necesidad de sistemas de vigilancia y prevención adecuados para afrontar en toda su magnitud este problema para la salud pública.

Eriptosis: mecanismos moleculares y su implicación en la enfermedad aterotrombótica

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Fernando Manzur-Jattin

2016-05-01

Conclusiones: La eriptosis se caracteriza por la disminución del volumen celular, la vesiculación y la translocación del fosfatidil serina hacia la superficie externa de la membrana plasmática. Las alteraciones en la distribución de los fosfolípidos favorecen los procesos de adhesión celular a la pared vascular, conllevando al deterioro de la microcirculación, lo cual puede ocasionar importantes trastornos a nivel cardiovascular. La comprensión y el esclarecimiento de la eriptosis pueden ser esenciales para la búsqueda de nuevas dianas terapéuticas, encaminadas a ofrecer otras alternativas farmacológicas en el tratamiento de la enfermedad cardiovascular.

Trastornos del sueño en las enfermedades neurodegenerativas

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Dr. C. Marcelo Miranda

2013-05-01

Full Text Available Las enfermedades degenerativas del cerebro son cada vez más frecuentes, debido al envejecimiento de la población en Chile y en prácticamente todas las regiones del mundo. Las alteraciones del sueño son un componente importante cada vez mejor reconocido en sus manifestaciones clínicas, si bien frecuentemente ignorados en muchas de las evaluaciones. No obstante, es muy importante reconocer estos trastornos porque dificultan el manejo óptimo de estas complejas enfermedades. Por ejemplo, cuadros como el trastorno conductual del sueño REM (por Rapid Eye Movements, en Inglés, un componente de los ciclos del sueño que incluye el fenómeno de “actuar los sueños” se han configurado como potenciales biomarcadores de la presencia de la enfermedad de Parkinson. Por lo tanto, se trata no sólo de identificar trastornos y manifestaciones específicas dentro del contexto de las enfermedades ya aludidas, sino que también de utilizar estos trastornos clave como elementos importantes en el diagnóstico precoz de las mismas. En esta revisión analizamos los principales problemas relacionados al sueño que es posible observar en este tipo de enfermedades, y que forman parte de las consideraciones esenciales para un manejo óptimo, actualizado e integral de estas enfermedades (Parasomnias, enfermedades neurodegenerativas, apneas del sueño.

Enfermedad de Gumboro. Histopatología de la Bursa de Fabricio en la enfermedad natural y experimental en pollos de engorde

OpenAIRE

E, Babaahmady; R, Joa.-; Julia, Noda.

2005-01-01

La Enfermedad de Gumboro, o Enfermedad Infecciosa de la Bolsa de Fabricio (EIBF) es una enfermedad viral, infectocontagiosa de los pollos jóvenes, que puede afectar al pollo de engorde provocando inmunosupresión y mortalidad. Las cepas del virus EIBF se diferencian en su patogenicidad basado en el efecto que producen en los órganos linfoides principalmente la bolsa de Fabricio y como consecuencia la reducida respuesta inmune a infecciones con otros patógenos o vacunas que se aplican. En este ...

Autodestrucción espontánea de una malformación arteriovenosa cerebral Spontaneous self-destruction of a cerebral arteriovenous malformation

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Antonio Guevara Melcón

2011-12-01

Full Text Available Se presenta una paciente que fue investigada y operada en el Hospital Universitario "Gral. Calixto García", portadora de una malformación arteriovenosa cerebral, que desapareció espontáneamente después de un cuadro neurológico de intensa gravedad. Arteriográficamente se comprobó que estaba asociada a un aneurisma arterial en su mismo sistema vascular cerebral. La paciente había sufrido 3 eventos neurológicos en orden ascendente de gravedad, y fue el último motivo de ingreso en la Unidad de Terapia Intensiva, con un nivel de 5 en la escala de Glasgow para el coma y sin signos meníngeos evidenciables. La lesión valorada como malformación arteriovenosa cerebral en las tomografías axiales cumputarizadas previas, no se evidenció en la panangiografía cerebral realizada en la fase de mejoría clínica relativa después de su etapa más crítica. Dicha angiografía demostró un aneurisma arterial homolateral a la malformación arteriovenosa ya desaparecida, el cual fue excluido de la circulación por presillamiento de su cuello sin eventos transoperatorios ni posoperatorios relevantes. Se realiza una revisión de la literatura al respecto.Authors present the case of a patient researched and operated on in the "General Calixto García" University Hospital presenting with a cerebral arteriovenous malformation disappeared spontaneously after a neurologic picture of intense severity. From the arteriographic point of view it was verified that it was associated with an arterial aneurysm present in her same cerebral vascular system. The patient has had three neurological events in rising order of severity which was the last reason for admission in the Intensive Therapy Unit (ITU with a level of 5 in the Glasgow scale for the coma and without obvious meningeal signs. The injury classified as a cerebral arteriovenous malformation according to the previous computerized axial tomographies was not evidenced in the cerebral panangiograpy carried out

Enfermedad injerto contra huesped: sus manifestaciones bucales

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Claudia Marcela Hernández Cancino

Full Text Available La enfermedad injerto contra huésped es la principal complicación que sufren los pacientes que han recibido trasplante alogénico. Se produce como consecuencia de una reacción inflamatoria exagerada mediada por los linfocitos del donante y estimulada por aquellos tejidos que han sido lesionados por la enfermedad de base, por las infecciones previas o por el tratamiento de acondicionamiento. El diagnóstico es clínico e histopatológico. Los pacientes presentan rash maculopapular pruriginoso y doloroso que puede extenderse por toda la superficie corporal, fiebre, vómito, náuseas, diarrea y anorexia. En la mucosa bucal se observan erosiones ulceradas, extremamente dolorosas y pueden ser la primera o la única manifestación detectable clínicamente de esta enfermedad. El objetivo es presentar un caso de enfermedad de injerto contra huésped. Se trata de una mujer de 54 años de edad con linfoma no-Hodgking, que recibió tratamiento con quimioterapia, radioterapia y trasplante de células madre hematopoyéticas en el 2009. Tres meses después, presentó lesiones en la piel diagnosticadas como enfermedad injerto contra huésped y tratadas con corticoesteroides, a los seis meses fue remitida al odontólogo porque se quejaba de ardor en la boca, xerostomía y dificultad para masticar, tenía úlceras en la mucosa bucal y en la lengua. En la ocasión recibió tratamiento con corticoesteroides, clorhexidina, orientaciones de higiene bucal y controles clínicos permanentes. Aunque existen protocolos para la prevención y el tratamiento de la enfermedad injerto contra el huésped, su frecuencia ha aumentado en los últimos años debido al incremento en el número de trasplantes. Por esta razón, es fundamental que el odontólogo forme parte del grupo multidisciplinario que asiste al paciente y que esté familiarizado con los signos y síntomas de esta enfermedad en la mucosa bucal, pues las manifestaciones clínicas pueden ser las únicas para

Effect of PPARγ Inhibition during Pregnancy on Posterior Cerebral Artery Function and Structure

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Siu-Lung eChan

2010-08-01

Full Text Available Peroxisome proliferator-activated receptor-γ (PPARγ, a ligand-activated transcription factor, has protective roles in the cerebral circulation, and, is highly activated during pregnancy. Thus, we hypothesized that PPARγ is involved in the adaptation of cerebral vasculature to pregnancy. Nonpregnant (NP and late-pregnant (LP rats were treated with a specific PPARγ inhibitor GW9662 (10 mg/kg/day, in food or vehicle for 10 days and vascular function and structural remodeling were determined in isolated and pressurized posterior cerebral arteries (PCA. Expression of PPARγ and angiotensin type 1 receptor (AT1R in cerebral (pial vessels was determined by real-time RT-PCR. PPARγ inhibition decreased blood pressure and increased blood glucose in NP rats, but not in LP rats. PPARγ inhibition reduced dilation to acetylcholine and sodium nitroprusside in PCA from NP (p<0.05 vs. LP-GW, but not LP rats. PPARγ inhibition tended to increase basal tone and myogenic activity in PCA from NP rats, but not LP rats. Structurally, PPARγ inhibition increased wall-thickness in PCA from both NP and LP rats (p<0.05, but increased distensibility only in PCA from NP rats. Pregnancy decreased expression of PPARγ and AT1R (p<0.05 in cerebral arteries that was not affected by GW9662 treatment. These results suggest that PPARγ inhibition had significant effects on the function and structure of PCA in the NP state, but appeared to have less influence during pregnancy. Down-regulation of PPARγ and AT1R in cerebral arteries may be responsible for the lack of effect of PPARγ in cerebral vasculature and may be part of the vascular adaptation to pregnancy.

Respuesta inmune en las enfermedades del periodonto : desde salud hasta enfermedad y sus implicaciones terapéuticas

OpenAIRE

Botero Torres, Javier Enrique

2009-01-01

Los cambios estructurales en las enfermedades periodontales, considerando desde gingivitis hasta periodontitis, son el resultado de un evento inflamatorio, que es iniciado y perpetuado por bacterias por largos períodos de tiempo. Una serie de eventos celulares y moleculares ocurren en diferentes grados de complejidad tan pronto las bacterias comienzan a acumularse alrededor de los dientes. No obstante, aunque las bacterias son necesarias para iniciar la enfermedad periodontal, es la respuesta...

Clinical implication and prognosis of normal baseline cerebral blood flow with impaired vascular reserve in patients with major cerebral artery occlusive disease

International Nuclear Information System (INIS)

Isozaki, Makoto; Arai, Yoshikazu; Kubota, Toshihiko; Kikuta, Ken-ichiro; Kudo, Takashi; Kiyono, Yasushi; Kobayashi, Masato; Okazawa, Hidehiko

2010-01-01

To investigate the prognosis of patients with cerebrovascular steno-occlusive disease who have preserved baseline cerebral blood flow (CBF) and reduced cerebral vasoreactivity (CVR), they were followed up after scans of positron emission tomography (PET). Fifty-seven patients with symptomatic unilateral major cerebral arterial occlusion or severe stenosis underwent O-15 gas and water PET scans to measure cerebral blood volume, metabolic rate of oxygen, oxygen extraction fraction (OEF), and CBF at the baseline and after acetazolamide administration. Thirty of them (mean age 60±10 years) had normal ipsilateral CBF, and were followed prospectively at least 30 months from the last ischemic event. They were medically treated for cerebral circulation and underlying diseases during follow-up periods. The primary endpoint was determined as stroke recurrence during the follow-up. Thirty patients were divided into two groups of reduced CVR (N=16, 63±8 years) and normal CVR (N=14, 56±10 years) on the basis of CVR values from healthy volunteers. None of them showed significant laterality in baseline CBF and OEF between the hemispheres although patients with reduced CVR showed a tendency of ipsilateral increases in OEF and CBV. Patients were followed up for 50.5±19.0 and 48.1±12.4 months in the reduced and normal CVR groups, respectively. Although one patient with reduced CVR died of heart disease, there was no incidence of ischemic events during follow-up periods for either group. In the present prospective study, patients with sufficient baseline CBF showed good prognosis and no difference in recurrent stroke risks even though they had poor CVR in the affected hemisphere, indicating that these patients can be treated by medication for cerebral circulation and baseline diseases if they have high risk factors for neurosurgical treatment. (author)

Functional genomics indicate that schizophrenia may be an adult vascular-ischemic disorder.

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Moises, H W; Wollschläger, D; Binder, H

2015-08-11

In search for the elusive schizophrenia pathway, candidate genes for the disorder from a discovery sample were localized within the energy-delivering and ischemia protection pathway. To test the adult vascular-ischemic (AVIH) and the competing neurodevelopmental hypothesis (NDH), functional genomic analyses of practically all available schizophrenia-associated genes from candidate gene, genome-wide association and postmortem expression studies were performed. Our results indicate a significant overrepresentation of genes involved in vascular function (P < 0.001), vasoregulation (that is, perivascular (P < 0.001) and shear stress (P < 0.01), cerebral ischemia (P < 0.001), neurodevelopment (P < 0.001) and postischemic repair (P < 0.001) among schizophrenia-associated genes from genetic association studies. These findings support both the NDH and the AVIH. The genes from postmortem studies showed an upregulation of vascular-ischemic genes (P = 0.020) combined with downregulated synaptic (P = 0.005) genes, and ND/repair (P = 0.003) genes. Evidence for the AVIH and the NDH is critically discussed. We conclude that schizophrenia is probably a mild adult vascular-ischemic and postischemic repair disorder. Adult postischemic repair involves ND genes for adult neurogenesis, synaptic plasticity, glutamate and increased long-term potentiation of excitatory neurotransmission (i-LTP). Schizophrenia might be caused by the cerebral analog of microvascular angina.

Hypertension-Induced Cerebral Small Vessel Disease Leading to Cognitive Impairment.

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Liu, Yang; Dong, Yan-Hong; Lyu, Pei-Yuan; Chen, Wei-Hong; Li, Rui

2018-03-05

Alzheimer's disease and vascular dementia are responsible for more than 80% of dementia cases. These two conditions share common risk factors including hypertension. Cerebral small vessel disease (CSVD) is strongly associated with both hypertension and cognitive impairment. In this review, we identify the pathophysiological changes in CSVD that are caused by hypertension and further explore the relationship between CSVD and cognitive impairment. We searched and scanned the PubMed database for recently published literatures up to December 2017. We used the keywords of "hypertension", "cerebral small vessel disease", "white matter lesions", "enlarged perivascular spaces", "lacunar infarcts", "cerebral microbleeds", and "cognitive impairment" in the database of PubMed. Articles were obtained and reviewed to analyze the hypertension-induced pathophysiological changes that occur in CSVD and the correlation between CSVD and cognitive impairment. In recent years, studies have demonstrated that hypertension-related changes (e.g., small vascular lesions, inflammatory reactions, hypoperfusion, oxidative stress, damage to autoregulatory processes and the blood-brain barrier, and cerebral amyloid angiopathy) can occur over time in cerebral small vessels, potentially leading to lower cognitive function when blood pressure (BP) control is poor or lacking. Both isolated and co-occurrent CSVD can lead to cognitive deterioration, and this effect may be attributable to a dysfunction in either the cholinergic system or the functionality of cortical and subcortical tracts. We explore the currently available evidence about the hypertensive vasculopathy and inflammatory changes that occur in CSVD. Both are vital prognostic indicators of the development of cognitive impairment. Future studies should be performed to validate the relationship between BP levels and CSVD progression and between the numbers, volumes, and anatomical locations of CSVD and cognitive impairment.

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

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Sheepsumon Viboolvorakul

2014-01-01

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

The Serial Change of Cerebral Hemodynamics by Vascular Territory after Extracranial-Intracranial Bypass Surgery in Patients with Atherosclerosis of Cerebral Arteries

International Nuclear Information System (INIS)

Hong, Il Ki; Kim, Jae Seung; Ahn, Jae Sung; Kwon, Sun Uck; Im, Ki Chun; Lee, Jai Hyuen; Moon, Dae Hyuk

2008-01-01

To assess the effect of extracranial-intracranial (EC-IC) bypass surgery on hemodynamic improvement, we evaluated serial regional cerebral hemodynamic change of the middle cerebral artery (MCA) in symptomatic patients with atherosclerotic occlusion of the internal carotid artery (ICA) or MCA using 99m Tc-ECD acetazolamide stress brain perfusion SPECT (Acetazolamide SPECT). The patients who had suffered a recent stroke with atherosclerotic ICA or MCA occlusion underwent EC-IC bypass surgery and Acetazolamide SPECT at 1 week before and three to six months after surgery. For image analysis, attenuation corrected images were spatially normalized to SPECT templates with SPM2. Anatomical automated labeling was applied to calculate mean counts of each Volume-Of-Interest (VOI). Seven VOIs of bilateral frontal, parietal, temporal regions of the MCA territory and the ipsilateral cerebellum were defined. Using mean counts of 7 VOIs, cerebral perfusion index and perfusion reserve index were calculated. Seventeen patients (M:F=12:5, mean age: 53±2yr) were finally included in the analysis. The cerebral blood flow of the parietal region increased at 1 week (p=0.003) and decreased to the preoperative level at 3-6 months (p=0.003). The cerebrovascular reserve of the frontal and parietal regions increased significantly at 1 week after surgery (p<0.01) and improved further at 3-6 months. Cerebrovascular reserve of the MCA territory was significantly improved at early postoperative period after EC-IC bypass and kept improved state during long-term follow-up, although cerebral blood flow did not significantly improved. Therefore, cerebrovascular reserve may be a good indicator of postoperative hemodynamic improvement resulted from bypass effect

The Serial Change of Cerebral Hemodynamics by Vascular Territory after Extracranial-Intracranial Bypass Surgery in Patients with Atherosclerosis of Cerebral Arteries

Energy Technology Data Exchange (ETDEWEB)

Hong, Il Ki; Kim, Jae Seung; Ahn, Jae Sung; Kwon, Sun Uck; Im, Ki Chun; Lee, Jai Hyuen; Moon, Dae Hyuk [Asan Medial Center, Ulsan University School of Medicine, Seoul (Korea, Republic of)

2008-02-15

To assess the effect of extracranial-intracranial (EC-IC) bypass surgery on hemodynamic improvement, we evaluated serial regional cerebral hemodynamic change of the middle cerebral artery (MCA) in symptomatic patients with atherosclerotic occlusion of the internal carotid artery (ICA) or MCA using {sup 99m}Tc-ECD acetazolamide stress brain perfusion SPECT (Acetazolamide SPECT). The patients who had suffered a recent stroke with atherosclerotic ICA or MCA occlusion underwent EC-IC bypass surgery and Acetazolamide SPECT at 1 week before and three to six months after surgery. For image analysis, attenuation corrected images were spatially normalized to SPECT templates with SPM2. Anatomical automated labeling was applied to calculate mean counts of each Volume-Of-Interest (VOI). Seven VOIs of bilateral frontal, parietal, temporal regions of the MCA territory and the ipsilateral cerebellum were defined. Using mean counts of 7 VOIs, cerebral perfusion index and perfusion reserve index were calculated. Seventeen patients (M:F=12:5, mean age: 53{+-}2yr) were finally included in the analysis. The cerebral blood flow of the parietal region increased at 1 week (p=0.003) and decreased to the preoperative level at 3-6 months (p=0.003). The cerebrovascular reserve of the frontal and parietal regions increased significantly at 1 week after surgery (p<0.01) and improved further at 3-6 months. Cerebrovascular reserve of the MCA territory was significantly improved at early postoperative period after EC-IC bypass and kept improved state during long-term follow-up, although cerebral blood flow did not significantly improved. Therefore, cerebrovascular reserve may be a good indicator of postoperative hemodynamic improvement resulted from bypass effect.

Computed tomographic findings of cerebral arterial ectasia

International Nuclear Information System (INIS)

Choi, Woo Suk; Ko, Young Ho; Lim, Jae Hoon

1987-01-01

The computed tomographic findings of cerebral arterial ectasia in 8 patients, of which 5 cases were angiographically documented, are reported. The ecstatic arteries, located predominantly in the suprasellar and interpeduncular cisterns, appeared as serpignous, tubular structures on the unenhanced scan. The enhanced CT scan demonstrated dense, sharply defined, homogeneous intraluminal enhancement. Until recently, the diagnosis of cerebral arterial ectasia was usually established by angiography. With introduction of CT it has become possible to noninvasively identify and characterize this vascular disorder and its associated intracranial complications. The vertebrobasilar dolichoectasia may be diagnosed by CT as an extra-axial lesion in the cerebellopontine angle. It enhances in a tubular fashion after intravenous injection of contrast.

Desigualdades sociales en la mortalidad de enfermedades por causas externas, tumores, enfermedades metabólicas en el departamento de Caldas 2010-2013

OpenAIRE

Marín Ocampo, Angela María

2017-01-01

Objetivo. Determinar las desigualdades sociales en la mortalidad de enfermedades por causas externas, enfermedades metabólicas y tumores en los municipios del departamento de Caldas en el período 2010-2013.

Desintegración de las praxias en la enfermedad de Alzheimer Disintegration of praxias in Alzheimer's disease: a case report

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Carlos A. Bardeci

1972-03-01

Full Text Available Se describe la sintomatologia clínica, los resultados de métodos auxiliares y de la punción biopsia cerebral de una paciente con enfermedad de Alzheimer. Se analizan los diversos aspectos clínicos, sosteniendose como posible determinar la individualidad clínica de la enfermedad de Alzheimer, dentro del capítulo de las demencias preseniles y su diagnóstico en vida. Las formas de apraxia presentes en esta observación confirman la correlación estrecha que existe entre los distintos niveles de su desintegración, à su relación con las perturbaciones del espacio al cual están genéticamente vinculadas; el espacio euclidiano para la apraxia constructiva, el espacio centrado en el propio cuerpo para la ideomotora y el concreto de manipulación de objetos para la ideatoria.The case of a patient with Alzheimer's disease is reported and some considerations about the clinical individuality of the disease and the characteristics shown by the disintegration of behavior are made. In the study, the following methods were used: neurological examinations focused especially on movement disturbances, ecoencephalography, electroencephalography, cerebral cintilography, right carotid arteriography and cerebral biopsy. The clinical aspects of the disease, just as the correlation of the data obtained by the auxiliary methods allow the formulation of the diagnosis, confirmed by right frontal cerebral puncture. The patient's clinical context shows the basic syndromes: 1 frontal with fixative amnesia, lack of interest, deterioration of the consciousness of situation and of the intellectual level, bilateral apprehension reflex; 2 parieto-temporo-occipital with indifference for the left hemibody, for the visual hemifield and for the space of this side. In addition, there arises a serious complication of motor behavior (praxias with the disintegration of all functional levels: instrumental (melokinesic apraxia, space linked to the body (ideomotor, Euclidean space

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

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Xia Zhou

2016-11-01

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

Male-female differences in upregulation of vasoconstrictor responses in human cerebral arteries.

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Hilda Ahnstedt

Full Text Available BACKGROUND AND PURPOSE: Male-female differences may significantly impact stroke prevention and treatment in men and women, however underlying mechanisms for sexual dimorphism in stroke are not understood. We previously found in males that cerebral ischemia upregulates contractile receptors in cerebral arteries, which is associated with lower blood flow. The present study investigates if cerebral arteries from men and women differ in cerebrovascular receptor upregulation. EXPERIMENTAL APPROACH: Freshly obtained human cerebral arteries were placed in organ culture, an established model for studying receptor upregulation. 5-hydroxtryptamine type 1B (5-HT1B, angiotensin II type 1 (AT1 and endothelin-1 type A and B (ETA and ETB receptors were evaluated using wire myograph for contractile responses, real-time PCR for mRNA and immunohistochemistry for receptor expression. KEY RESULTS: Vascular sensitivity to angiotensin II and endothelin-1 was markedly lower in cultured cerebral arteries from women as compared to men. ETB receptor-mediated contraction occurred in male but not female arteries. Interestingly, there were similar upregulation in mRNA and expression of 5-HT1B, AT1, and ETB receptors and in local expression of Ang II after organ culture. CONCLUSIONS AND IMPLICATIONS: In spite of receptor upregulation after organ culture in both sexes, cerebral arteries from women were significantly less responsive to vasoconstrictors angiotensin II and endothelin-1 as compared to arteries from men. This suggests receptor coupling and/or signal transduction mechanisms involved in cerebrovascular contractility may be suppressed in females. This is the first study to demonstrate sex differences in the vascular function of human brain arteries.

Tratamiento de la enfermedad de Graves Basedow

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Hernando Vargas-Uricoechea

2014-05-01

Full Text Available Se realizó una revisión narrativa rigurosa de la literatura inglesa y en español sobre diferentes aspectos de la Enfermedad de Graves-Basedow e hipertiroidismo. Esta patología –parte de la llamada “enfermedad tiroidea autoinmune”- se produce como consecuencia de la presencia de anticuerpos circulantes que se unen y activan al receptor de tirotropina, desencadenándose generalmente el hipertiroidismo en asociación con un estrés agudo. En este artículo actualizamos tanto el manejo de hipertiroidismo como el de problemas especiales con el que puede estar asociado. La fisiopatología y el diagnóstico de la Enfermedad de Graves-Basedow son motivo de otra publicación.

Reduced vascular amyloid burden at microhemorrhage sites in cerebral amyloid angiopathy

NARCIS (Netherlands)

van Veluw, Susanne J.; Kuijf, Hugo J.; Charidimou, Andreas; Viswanathan, Anand; Biessels, Geert Jan; Rozemuller, Annemieke J M; Frosch, Matthew P.; Greenberg, Steven M.

Microhemorrhages are strongly associated with advanced cerebral amyloid angiopathy (CAA). Although it has been frequently proposed that the deposition of Aβ in the walls of cortical vessels directly causes microhemorrhages, this has not been studied in great detail, mainly because the ruptured

Fabrication of cerebral aneurysm simulator with a desktop 3D printer.

Science.gov (United States)

Liu, Yu; Gao, Qing; Du, Song; Chen, ZiChen; Fu, JianZhong; Chen, Bing; Liu, ZhenJie; He, Yong

2017-05-17

Now, more and more patients are suffering cerebral aneurysm. However, long training time limits the rapid growth of cerebrovascular neurosurgeons. Here we developed a novel cerebral aneurysm simulator which can be better represented the dynamic bulging process of cerebral aneurysm The proposed simulator features the integration of a hollow elastic vascular model, a skull model and a brain model, which can be affordably fabricated at the clinic (Fab@Clinic), under $25.00 each with the help of a low-cost desktop 3D printer. Moreover, the clinical blood flow and pulsation pressure similar to the human can be well simulated, which can be used to train the neurosurgical residents how to clip aneurysms more effectively.

Post Traumatic Cerebral Oedema in Severe Head Injury is Related to Intracranial Pressure and Cerebral Perfusion Pressure but not to Cerebral Compliance

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U Nujaimin

2009-07-01

Full Text Available This was a prospective cohort study, carried out in the Neuro Intensive Care Unit, Department of Neurosciences, Hospital Universiti Sains Malaysia, Kubang Kerian Kelantan. The study was approved by the local ethics committee and was conducted between November 2005 and September 2007 with a total of 30 patients included in the study. In our study, univariate analysis showed a statistically significant relationship between mean intracranial pressure (ICP as well as cerebral perfusion pressure (CPP with both states of basal cistern and the degree of diffuse injury and oedema based on the Marshall classification system. The ICP was higher while CPP and compliance were lower whenever the basal cisterns were effaced in cases of cerebral oedema with Marshall III and IV. In comparison, the study revealed lower ICP, higher mean CPP and better mean cerebral compliance if the basal cisterns were opened or the post operative CT brain scan showed Marshall I and II. These findings suggested the surgical evacuation of clots to reduce the mass volume and restoration of brain anatomy may reduce vascular engorgement and cerebral oedema, therefore preventing intracranial hypertension, and improving cerebral perfusion pressure and cerebral compliance. Nevertheless the study did not find any significant relationship between midline shifts and mean ICP, CPP or cerebral compliance even though lower ICP, higher CPP and compliance were frequently observed when the midline shift was less than 0.5 cm. As the majority of our patients had multiple and diffuse brain injuries, the absence of midline shift did not necessarily mean lower ICP as the pathology was bilateral and even when after excluding the multiple lesions, the result remained insignificant. We assumed that the CT brain scan obtained after evacuation of the mass lesion to assess the state basal cistern and classify the diffuse oedema may prognosticate the intracranial pressure and cerebral perfusion pressure

La Tuberculosis, Una Enfermedad Modificada*

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Valentin Malagón Castro

1993-12-01

Full Text Available

Con ocasión de un estudio de revisión que hemos llevado a cabo recientemente sobre la tuberculosis osteoarticular, *** se ha apreciado un cambio notable en las características y manifestaciones de esta enfermedad.

Hemos sido testigos del comportamiento de la tuberculosis en los últimos 40 años. Realizamos la tesis profesional en el Hospital de niños de la Misericordia de Bogotá en el año 1950 (86, basada en el análisis de más de 300 enfermos de Mal de Pott tratados con pobres resultados en esa institución en la época prequimioterápica. Efectuamos estudios de control del tratamiento quirúrgico de esa afección en el Hospital Infantil Lorencita Villegas de Santos y publicamos sus resultados en los años 1975,1980 Y1987 (85-87-88. Los pacientes correspondientes a estas nuevas series, ya en la época de la quimioterapia moderna, presentaban un mejor pronóstico vital y funcional. Cuadro 1A.

En el decenio 1978-1988 asistimos al descenso espectacular de la frecuencia de tuberculosis osteoarticular en las salas de nuestros hospitales. Posteriormente hemos sido igualmente testigos de su lenta y progresiva reaparición.

El estudio actual nos ha mostrado profundos cambios, como ya se ha dicho, en el comportamiento de la entidad, por lo que estamos de acuerdo en denominarla: La tuberculosis, una enfermedad modificada, diferente a la que hasta hace un década parecía derrotada, vencida por las nuevas drogas y las recientes técnicas quirúrgicas.

La actual es una enfermedad diferente que ha tomado una fuerza avasalladora que amenaza con volverse resistente al tratamiento específico y dar lugar a una pandemia de incalculables proporciones y de terribles consecuencias para la humanidad.

El objeto de publicar este estudio es recordar a nuestros colegas, en especial a aquellos de las nuevas promociones que quizás no han tenido la oportunidad de estar en contacto con pacientes de tuberculosis osteoarticular, de

Multiple cerebral cavernous malformations in a pediatric patient with Turner syndrome

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Nicholas T. Gamboa, B.S.

2017-12-01

Full Text Available Turner syndrome (TS; 45,X0 is a relatively common chromosomal disorder that is associated with characteristic phenotypic stigmata: short stature, webbed neck, broad (“shield” chest with widely spaced nipples, cubitus valgus, ovarian dysgenesis (“streak ovary”, primary amenorrhea, renal anomalies, lymphedema of the hands or feet, and various vascular abnormalities. Abnormalities of the cardiovascular system are commonly reported in patient with TS, and vascular anomalies affecting various other organ systems are also frequently reported. To date, however, few reports of intracranial vascular malformations exist. The authors report the case of a patient with TS who was found to have multiple cerebral cavernous malformations on imaging.

Permanent vascular access in patients with end-stage renal disease, Brazil Acceso vascular permanente en pacientes renales crónicos terminales en Brasil Acesso vascular permanente em pacientes renais crônicos terminais no Brasil

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Gisele Macedo da Silva

2011-04-01

Full Text Available OBJECTIVE: To assess factors associated with the establishment of permanent vascular access for patients with end-stage renal disease. METHODS: Cross-sectional study conducted in a nationally representative sample of Brazilian end-stage renal disease patients in dialysis and transplant centers during 2007. The sample comprised only patients who received hemodialysis as a primary therapy modality and reported the type of vascular access for their primary hemodialysis treatment (N=2,276. Data were from the TRS Project - "Economic and Epidemiologic Evaluation of Modalities of Renal Replacement Therapy in Brazil". Multiple logistic regression analysis was used to assess factors associated with the establishment of permanent vascular access in these patients. RESULTS: About 30% of the patients studied had an arteriovenous vascular access. The following factors were associated with a lower likelihood of having an arteriovenous vascular access as a primary type of access: time of hemodialysis start since the diagnosis of chronic renal failure OBJETIVO: Analizar factores asociados a la provisión de acceso vascular arteriovenoso en Brasil. MÉTODOS: Estudio transversal, nacionalmente representativo, con pacientes con enfermedad renal crónica terminal acompañados en servicios de diálisis o en centros transplantadores en el año de 2007. La muestra incluyó pacientes que tuvieron la hemodiálisis como primera modalidad de tratamiento y que sabían con que tipo de acceso vascular habían iniciado el tratamiento (N=2.276. Los datos son oriundos del Proyecto TRS - "Evaluación económica-epidemiológica de las modalidades de Terapia renal Sustitutiva en Brasil". Fue utilizada la regresión logística múltiple. RESULTADOS: Aproximadamente 30% de los pacientes tenían acceso vascular arteriovenoso. Los factores asociados a la baja probabilidad de tener acceso vascular arteriovenoso como primer tipo de acceso fueron: tiempo de diagnóstico de enfermedad

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

Science.gov (United States)

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

2012-01-01

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

Genes y variantes polimórficas asociadas a la enfermedad cardiovascular

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Eliana C. Portilla

2014-09-01

Full Text Available La aterosclerosis se considera como la principal causante de enfermedades cardiovasculares. Es una enfermedad multifactorial, caracterizada por procesos inflamatorios y la internalización continua de moléculas lipídicas al interior del vaso. Los estudios de genes candidato han proporcionado conocimiento acerca de la fisiopatología de esta enfermedad y han permitido la postulación de algunos polimorfismos como responsables de la susceptibilidad genética en diversas poblaciones. En particular, estos polimorfismos que modulan ciertas vías moleculares tales como el estrés oxidativo, el metabolismo lipídico y la trombogénesis se asocian con el desarrollo de las enfermedades cardiovasculares. Se han conducido varios estudios para identificar nuevas variantes asociadas con la enfermedad que han permitido el descubrimiento de nuevas vías de la enfermedad. Aunque el hallazgo de nuevos genes asociados a la enfermedad cardiovascular a través de enfoques como el escaneo global del genoma ha contribuido al entendimiento del desarrollo de esta condición, el conocimiento aún es limitado y poco concluyente. El objetivo de esta revisión es identificar los genes y las variantes polimórficas asociadas a la enfermedad cardiovascular, de acuerdo con los diferentes enfoques de análisis de asociación genética.

Caracterización de pacientes diabéticos de tipo 2 con complicaciones vasculares y riesgo de ateroesclerosi

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Milagros Violeta Font Difour

2014-12-01

Full Text Available Se realizó un estudio observacional, descriptivo y prospectivo para caracterizar a 200 pacientes diabéticos de tipo 2, diagnosticados con complicaciones vasculares y riesgo de ateroesclerosis, los cuales fueron ingresados en el Servicio de Medicina Interna del Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba, desde junio del 2010 hasta igual mes del 2011. Entre las complicaciones más frecuentes figuraron: enfermedades cardiovasculares (29,5 %, neuropatía (21,5 % y retinopatía (19,5 %. Prevalecieron los afectados con 3 complicaciones (40,5 %, los que tenían un tiempo de evolución de la enfermedad de 11-15 años (38,0 %; además de la hiperlipidemia (35,0 %, la hipertensión arterial (32,0 % y el tabaquismo (26,5 % como factores de riesgo. Se concluye que con un enfoque multidisciplinario en el tratamiento y control de esta enfermedad se logra mejorar el pronóstico de los afectados.

Modeling Cerebral Blood Flow Control During Posture Change from Sitting to Standing

DEFF Research Database (Denmark)

Olufsen, Mette; Tran, Hien; Ottesen, Johnny T.

2004-01-01

, the heart, and venous valves. We use physiologically based control mechanisms to describe the regulation of cerebral blood velocity and arterial pressure in response to orthostatic hypotension resulting from postural change. Beyond active control mechanisms we also have to include certain passive non......Hypertension, decreased cerebral blood flow, and diminished cerebral blood flow regulation, are among the first signs indicating the presence of cerebral vascular disease. In this paper, we will present a mathematical model that can predict blood flow and pressure during posture change from sitting......-linearities in some of the compliance-pressure and resistance-pressure relationships. Futhermore, an acurate and physiologically based submodel, describing the dynamics of how gravity effects the blood distribution during suspine changes, is included. To justify the fidelity of our mathematical model and control...

Cerebral and extracerebral vasoreactivity in symptomatic lacunar stroke patients: a case-control study.

Science.gov (United States)

Deplanque, Dominique; Lavallee, Philippa C; Labreuche, Julien; Gongora-Rivera, Fernando; Jaramillo, Arturo; Brenner, David; Abboud, Halim; Klein, Isabelle F; Touboul, Pierre-Jean; Vicaut, Eric; Amarenco, Pierre

2013-08-01

Whether cerebral artery endothelial dysfunction is a key factor of symptomatic lacunar stroke and cerebral small vessel disease remains unclear. Cerebral and extracerebral vasoreactivity were measured in 81 patients with recent symptomatic lacunar stroke and in 81 control subjects matched for main vascular risk factors. Cerebral vasoreactivity and carotid endothelial-dependent vasodilation were measured after five-minutes of carbon dioxide-induced hypercapnia. Brachial endothelial-dependent vasodilation was assessed after hyperemia induced by deflating a cuff around the forearm previously inflated to 200 mmHg for four-minutes. Carotid and brachial endothelial-independent vasodilation were measured five-minutes after administration of sublingual nitroglycerin 300 μg. Brain magnetic resonance imaging were analyzed in lacunar stroke patients. One-month after stroke onset, patients had more severely impaired cerebral vasoreactivitys than matched controls (mean ± standard deviation, 14·4 ± 12·1% vs. 19·4 ± 17·4%; P = 0·049). Severe alterations of both carotid and brachial endothelial-dependent and at a lesser degree of carotid and brachial endothelial-independent vasodilation were observed in both groups. After adjustment for confounders, subjects with a cerebral vasoreactivity value in the two lower tertiles (≤19·6%) were more likely to have had a symptomatic lacunar stroke (adjusted odds ratio, 3·78; 95% confidence interval, 1·42 to 10·08; P = 0·008). Only alteration of brachial endothelial-independent vasodilation correlated with parenchymal abnormalities, namely microbleeds and leukoaraiosis. While abnormalities in extracerebral vasoreactivity seem related to vascular risk factors, the severity of endothelial dysfunction in cerebral arteries may be determinant in the occurrence of symptomatic lacunar stroke in patients with small vessel disease. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke

EVALUACIÓN NEUROPSICOLÓGICA EN LA ENFERMEDAD DE ALZHEIMER: MEMORIA EPISÓDICA Y SEMÁNTICA.

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Ana Comesaña

2009-01-01

Full Text Available Este trabajo tiene como objetivo realizar una revisión del proceso de evaluación neuropsicológica en pacientes con Alzheimer (EA, específicamente la referida a la memoria episódica y semántica. La enfermedad de Alzheimer es la principal forma de demencia. Es uno de los problemas sanitarios, sociales y culturales más importantes en actualidad. El diagnóstico y la diferenciación entre el envejecimiento normal y patológico son dificultosos en los primeros momentos, por lo tanto, la evaluación neuropsicológica cumple un papel fundamental. Los criterios utilizados actualmente son los del DSM IV (American Psychiatric Association, 1994 y los del NINCDS-ADRDA (Instituto Nacional para los Desórdenes Neurológicos, de la Comunicación y el Accidente Cerebro Vascular y la Asociación para la Enfermedad de Alzheimer y Desórdenes Relacionados (McKhann G, Drachman D, Folstein M, y col., 1984, y exigen que el diagnóstico de EA probable se corrobore por evaluación neuropsicológica, además de la evaluación clínica y otros estudios. A partir de la división de la memoria a largo plazo en semántica y episódica, se crearon pruebas específicas para su evaluación neuropsicológica en distintas patologías, incluyendo la EA. De esta manera, se realizó una importante contribución a la detección temprana del deterioro de la memoria que es característico de la enfermedad.

Vascular Care in Patients With Alzheimer Disease With Cerebrovascular Lesions Slows Progression of White Matter Lesions on MRI The Evaluation of Vascular Care in Alzheimer's Disease (EVA) Study

NARCIS (Netherlands)

Richard, Edo; Gouw, Alida A.; Scheltens, Philip; van Gool, Willem A.

2010-01-01

Background and Purpose-White matter lesions (WMLs) and cerebral infarcts are common findings in Alzheimer disease and may contribute to dementia severity. WMLs and lacunar infarcts may provide a potential target for intervention strategies. This study assessed whether multicomponent vascular care in

Enfermedades poco comunes: una prioridad de los sistemas de salud

OpenAIRE

RAP

2017-01-01

Las enfermedades poco comunes, incluidas las de origen genético, son aquellas enfermedades que tienen una prevalencia baja, menor de 5 casos por cada 10.000 habitantes en la comunidad, según la definición de la Unión Europea. Estas enfermedades tienen ciertas características comunes. Son, en su mayor parte, degenerativas y constituyen una prioridad de los sistemas de salud.

Enfermedades pulmonares intersticiales en el niño

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Roberto Razón Behar

Full Text Available Las enfermedades pulmonares intersticiales en el niño, comprenden un gran y heterogéneo grupo de raras enfermedades difusas pulmonares de morbilidad variada. Se caracterizan por cambios inflamatorios y fibróticos que causan remodelación de las paredes alveolares y de las vías respiratorias distales, y ocasionan un defecto restrictivo funcional y una alteración en el intercambio gaseoso, con hipoxemia progresiva. Son muchas las enfermedades que pueden afectar al intersticio pulmonar y múltiples las formas etiológicas causadas por una variedad de procesos patológicos, que incluyen, factores genéticos, asociación a enfermedades sistémicas, así como a respuestas inflamatorias o fibróticas a diferentes estímulos. Sin embargo, algunas veces su origen es desconocido, y se catalogan entonces como idiopáticas. Los neumólogos pediátricos han tratado de clasificar los casos de las enfermedades pulmonares intersticiales en las diferentes categorías descritas originalmente en adultos, pero, en realidad, existen formas del adulto que no se observan en la infancia, y formas únicas de presentación pediátrica. Se señala la importancia del conocimiento de estas entidades, particularmente las de origen desconocido o idiopáticas.

Superficial temporal artery calcification in patients with end-stage renal disease: Association with vascular risk factors and ischemic cerebrovascular disease

International Nuclear Information System (INIS)

Anwar, Zeeshan; Zan, Elcin; Carone, Marco; Ozturk, Arzu; Sozio, Stephen M; Yousem, David M

2011-01-01

Extracranial superficial temporal artery (STA) calcification is an unusual finding seen in patients with chronic kidney disease and has unknown ramifications with respect to intracranial ischemic disease. We sought to determine the association between the risk factors for vascular calcification and this rare phenomenon, in patients with chronic renal failure, and to assess the coexistence of cerebral ischemia. Medical records and laboratory data on risk factors for vascular calcification were retrospectively retrieved for 453 patients with a discharge diagnosis of end-stage renal disease (ESRD). CT head examinations were reviewed to identify and associate STA calcification with 1) risk factors for the vascular calcification, 2) intracranial artery calcification, and 3) cerebral ischemia (white matter and/or cortical ischemic changes). STA calcification was present in 9.9% (45/453) of the studied cohort. The prevalence of cerebral ischemia was 24.4% (11/45) in patients with STA calcification and 9.3% (38/408) in patients without it. Diabetes mellitus (OR: 2.56, 95% CI: 1.059-6.208; P=0.037) was independently associated with the risk of STA calcification. The risk of cerebral ischemia, however, was not related to STA calcification (P=0.221). The presence of diabetes mellitus is important in describing the risk of STA calcification in patients with ESRD, whereas age, gender, hypertension, serum calcium, serum phosphate, or serum hemoglobin levels are not. The risk of cerebral ischemia is not related to STA calcification but has the strongest association with diabetes mellitus

Predictors of short-term outcome in patients with acute middle cerebral artery occlusion: unsuitability of fluid-attenuated inversion recovery vascular hyperintensity scores

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Chan-chan Li

2018-01-01

Full Text Available Fluid-attenuated inversion recovery (FLAIR vascular hyperintensity (FVH is used to assess leptomeningeal collateral circulation, but clinical outcomes of patients with FVH can be very different. The aim of the present study was to assess a FVH score and explore its relationship with clinical outcomes. Patients with acute ischemic stroke due to middle cerebral artery M1 occlusion underwent magnetic resonance imaging and were followed up at 10 days (National Institutes of Health Stroke Scale and 90 days (modified Rankin Scale to determine short-term clinical outcomes. Effective collateral circulation indirectly improved recovery of neurological function and short-term clinical outcome by extending the size of the pial penumbra and reducing infarct lesions. FVH score showed no correlation with 90-day functional clinical outcome and was not sufficient as an independent predictor of short-term clinical outcome.

El papel del ejercicio físico en la inducción de BDNF y sus vías de señalización en el sistema nervioso central. Aplicación neurobiológica en modelos sanos y terapéutica en la enfermedad de Alzheimer

OpenAIRE

Pareja Galeano, Helios

2014-01-01

La actividad física previene numerosas patologías y mejora muchos rasgos fisiopatológicos en diferentes enfermedades. El ejercicio ha sido asociado clásicamente con beneficios en desórdenes musculares y metabólicos. Sin embargo, los efectos del ejercicio en la función cerebral, especialidad conocida como “Neurobiología del ejercicio”, han cobrado gran importancia en los últimos años. Los efectos beneficiosos del ejercicio físico han sido establecidos en muchas enfermedades tales como la en...

Protective effects of D-Limonene against transient cerebral ischemia in stroke-prone spontaneously hypertensive rats.

Science.gov (United States)

Wang, Xifeng; Li, Gang; Shen, Wei

2018-01-01

Stroke is a leading cause of disability and death world-wide and there is currently a lack of effective treatments for acute stroke. D-Limonene is a common natural monocyclic monoterpene possessing various activities. The present study aimed to evaluate the therapeutic efficacy of D-limonene against ischemia-associated cerebral injury in hypertensive SHRsp rats. Although systolic blood pressure was not altered by ischemia, D-Limonene decreased the systolic blood pressure of SHRsp rats following stroke. Induction of stroke resulted in increased escape latency time, decreased time spent in the target quadrant in the probe trial, decreased capacity to distinguish between familiar objects and novel objects, and increased sensory neglect in the SHRsp rat, however these symptoms were significantly inhibited by D-limonene. D-limonene also decreased the cerebral infarct size in the SHRsp rats following stroke. D-Limonene markedly decreased the mRNA expression of interleukin-1β, monocyte chemoattractant protein-1 and cyclooxygenase-2 in SHRsp rats following stroke. The mRNA expression of vascular endothelial growth factor in the brain of SHRsp rats following stroke was significantly increased by D-Limonene. D-Limonene increased the activities of superoxide dismutase and catalase, decreased the malondialdehyde level, increased glutathione content and reduced the DHE-staining in SHRsp rats following stroke. Overall, inhibition of cerebral inflammation, vascular remodeling and antioxidant activities of D-Limonene may be involved in the protective effects against ischemia-induced damage in SHRsp rats. The present study identified D-Limonene as a potential therapeutic candidate for treatment of stroke-associated cerebral and vascular damage under conditions of hypertension.

Normal Control Study of Cerebral Blood Flow by 99mTc HM-PAO SPECT

International Nuclear Information System (INIS)

Koong, Sung Soo; Moon, Dae Hyuk; Lee, Bum Woo; Lee, Kyung Han

1989-01-01

Regional cerebral perfusion was evaluated in 15 normal controls by single photon emission computed tomography using 99m Tc HM-PAO. For quantitative analysis, 13 pairs of homologous region of interest (ROI) were drawn on three transverse slices matching the vascular territories and cerebral cortices, and normal values of 3 semiquantitative indices including 'Right to left ratio' (R/L ratio), 'Regional index' (RI), and 'Region to cerebellum ratio (R/cbll ratio) were calculated. Mean values of R/L ratios of homologous regions were ranged from 0.985 to 1.023, and mean ± 2 s.d. of all regions did not exceed 11% of mean. Significant difference of Rls (mean count per voxel of a ROI/mean count per voxel of total ROls) between regions were found (p<0.001) with highest values in occipital cortex and cerebellum. After attenuation correction, Rls in deep gray, cranial portion of anterior cerebral artery and vascular territories in the 2nd slice increased significantly (p<0.05-0.001) hut vise versa in other ROIs. Region to cerebellum ratios also showed regional difference similar to Rls.

Papel de la fisioterapia en la enfermedad de Alzheimer

OpenAIRE

Lallana Jiménez, Lucía

2013-01-01

La enfermedad de Alzheimer es una enfermedad neurodegenerativa que representa entre el 50% y el 60% de las demencias. Se caracteriza por déficits cognitivos, desorientación espacio-temporal y pérdida de memoria a corto plazo, lo cual da lugar a una dificultad en la realización de las tareas cotidianas por parte del enfermo. La enfermedad evoluciona a los largo de cuatro estadios: -Fase 1: se caracteriza por perdidas de memoria a corto plazo pero el paciente es todavía relativamente independie...

Tratamiento de la enfermedad de Hansen en Colombia: medicalización y control de la enfermedad a lo largo del siglo XX

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Natalia Botero-Jaramillo

2017-09-01

Full Text Available Objetivo: investigar el tratamiento de la enfermedad de Hansen durante el siglo XX en Colombia, para analizar el proceso de medicalización, la biopolítica, el significado de la curación y su impacto en el control de la enfermedad y en los enfermos. Metodología: estudio histórico, descriptivo y analítico sobre los tratamientos para la enfermedad de Hansen a lo largo del siglo XX, por medio de metodologías cualitativas como entrevistas con relatos de vida y entrevistas temáticas, y se trabajó con fuentes documentales primarias y secundarias en archivos nacionales y locales. Resultados y discusión: La enfermedad de Hansen, causada por el microorganismo Mycobacterium leprae, fue controlada mediante el aislamiento y reclusión de los enfermos de lepra en hospitales y lazaretos. El desarrollo de algunos tratamientos y el descubrimiento de la terapia antibiótica, las sulfas, que representó una cura efectiva desde la medicina y su poder político y social, participaron en la transformación de las políticas de manejo de la enfermedad y de la comprensión de la misma, en los Lazaretos de Contratación y Agua de Dios.

Absceso cerebral en niños

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José de Jesús Goyo-Rivas

1999-03-01

Full Text Available Se presentan 23 pacientes con absceso cerebral, los cuales fueron estudiados en el Hospital Universitario de los Andes, Mérida?Venezuela, en un período de 15 años (1979-1994 y en edades comprendidas entre 0 mes y 14 años. Se encontró 1 caso de absceso cerebral por cada 1 600 hospitalizaciones. Se halló la mayor incidencia de la enfermedad en la edad escolar (43,4 % y un predominio en el sexo masculino (52,1 %. Entre los factores predisponentes se muestran: otomastoiditis con 30,4 %; posoperatorio neuroquirúrigico, 21,7 %; sinusitis, 17,3 %; meningitis, 17,3 %; cardiopatías congénitas, 8,6 % y celulitis periorbitaria, 4,3%. En 19 pacientes el absceso fue único y en 4 múltiples. Cinco de los abscesos fueron multiloculados. En el 61,9 % de los pacientes la enfermedad tenía más de una semana de evolución. La triada clásica (cefalea-fiebre-focalización neurológica se presentó en 9/23 pacientes (39,1 %. Doce de los pacientes recibieron tratamiento médico-quirúrgico. El Staphylococcus aureus fue el germen aislado con mayor frecuencia (20 % asociado al posoperatorio neuroquirúrgico y Enterobacterias (33 % asociadas a las infecciones otomastoideas. La tasa de mortalidad fue de 34,7 %. El absceso cerebral en niños continúa siendo un reto diagnóstico y de tratamiento para el clínico.23 patients aged 0-14 with brain abscess that were studied at the University Hospital of Los Andes, Mérida-Venezuela, during a period of 15 years (1979-1994 are presented. It was found a case of brain abscess per 1 600 hospitalizations. The highest incidence of the disease was observed at school age (43,4 % and among males (52,1 %. Some of the predisposing factors were: otomastoiditis with 30,4 %; neurosurgical postoperative, 21,7 %; sinusitis, 17,3 %; meningitis, 17,3 %; congenital heart disease, 8,6 %; and periorbital cellulitis, 4,3 %. In 19 patients the abscess was unique, and in 4 it was multiple. 5 of the abscesses were multiloculated. In 61

Vascular Contributions to Cognitive Impairment and Dementia

Science.gov (United States)

Gorelick, Philip B.; Scuteri, Angelo; Black, Sandra E.; DeCarli, Charles; Greenberg, Steven M.; Iadecola, Costantino; Launer, Lenore J.; Laurent, Stephane; Lopez, Oscar L.; Nyenhuis, David; Petersen, Ronald C.; Schneider, Julie A.; Tzourio, Christophe; Arnett, Donna K.; Bennett, David A.; Chui, Helena C.; Higashida, Randall T.; Lindquist, Ruth; Nilsson, Peter M.; Roman, Gustavo C.; Sellke, Frank W.; Seshadri, Sudha

2013-01-01

Background and Purpose This scientific statement provides an overview of the evidence on vascular contributions to cognitive impairment and dementia. Vascular contributions to cognitive impairment and dementia of later life are common. Definitions of vascular cognitive impairment (VCI), neuropathology, basic science and pathophysiological aspects, role of neuroimaging and vascular and other associated risk factors, and potential opportunities for prevention and treatment are reviewed. This statement serves as an overall guide for practitioners to gain a better understanding of VCI and dementia, prevention, and treatment. Methods Writing group members were nominated by the writing group co-chairs on the basis of their previous work in relevant topic areas and were approved by the American Heart Association Stroke Council Scientific Statement Oversight Committee, the Council on Epidemiology and Prevention, and the Manuscript Oversight Committee. The writing group used systematic literature reviews (primarily covering publications from 1990 to May 1, 2010), previously published guidelines, personal files, and expert opinion to summarize existing evidence, indicate gaps in current knowledge, and, when appropriate, formulate recommendations using standard American Heart Association criteria. All members of the writing group had the opportunity to comment on the recommendations and approved the final version of this document. After peer review by the American Heart Association, as well as review by the Stroke Council leadership, Council on Epidemiology and Prevention Council, and Scientific Statements Oversight Committee, the statement was approved by the American Heart Association Science Advisory and Coordinating Committee. Results The construct of VCI has been introduced to capture the entire spectrum of cognitive disorders associated with all forms of cerebral vascular brain injury—not solely stroke—ranging from mild cognitive impairment through fully developed

Microcephalic osteodysplastic primordial dwarfism type II (MOPD II) with multiple vascular complications misdiagnosed as Dubowitz syndrome.

Science.gov (United States)

Dieks, Jana-Katharina; Baumer, Alessandra; Wilichowski, Ekkehard; Rauch, Anita; Sigler, Matthias

2014-09-01

To date, the genetic basis of Dubowitz syndrome (short stature, microcephaly, facial abnormalities, eczema) is unknown and vascular complications are not known to be associated with this syndrome. In microcephalic osteodysplastic primordial dwarfism type II (MOPD II; disproportionate short statue, microcephaly, facial abnormalities), however, cerebral aneurysms and other vascular abnormalities are frequent complications. MOPD II is a genetic disorder caused by mutations in the pericentrin (PCNT) gene (21q22). We report on a patient who came to our attention as a 22-year-old with subarachnoid bleeding due to a ruptured cranial aneurysm. Until then, the patient was thought and published to have Dubowitz syndrome; previously, he was treated with coronary bypass surgery for extensive coronary angiopathy. Consecutive genetic testing revealed MOPD II. After clinical stabilization, the patient was discharged to a specialized rehabilitation center where he died due to re-rupture of a cranial aneurysm. In patients with short stature-especially when clinical features are accompanied by vascular complications-MOPD II should be considered as a differential diagnosis leading to consecutive genetic testing. After detection of mutations in the PCNT gene, a full vascular status including cerebral imaging and cardiac evaluation needs to be determined in order to analyze vascular abnormalities and initiate prophylactic treatment.

Neuroradiological findings in vascular dementia

Energy Technology Data Exchange (ETDEWEB)

Guermazi, Ali; Miaux, Yves; Suhy, Joyce; Pauls, Jon; Lopez, Ria [Synarc, Inc., Department of Radiology Services, San Francisco, CA (United States); Rovira-Canellas, Alex [Hospital General Universitari Vall d' Hebron, Unita de Resonancia Magnetica, Barcelona (Spain); Posner, Holly [Eisai, Inc., Teaneck, NJ (United States)

2007-01-15

There are multiple diagnostic criteria for vascular dementia (VaD) that may define different populations. Utilizing the criteria of the National Institute of Neurological Disorders and Stroke and Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS-AIREN) has provided improved consistency in the diagnosis of VaD. The criteria include a table listing brain imaging lesions associated with VaD. The different neuroradiological aspects of the criteria are reviewed based on the imaging data from an ongoing large-scale clinical trial testing a new treatment for VaD. The NINDS-AIREN criteria were applied by a centralized imaging rater to determine eligibility for enrollment in 1,202 patients using brain CT or MRI. Based on the above data set, the neuroradiological features that are associated with VaD and that can result from cerebral small-vessel disease with extensive leukoencephalopathy or lacunae (basal ganglia or frontal white matter), or may be the consequence of single strategically located infarcts or multiple infarcts in large-vessel territories, are illustrated. These features may also be the consequence of global cerebral hypoperfusion, intracerebral hemorrhage, or other mechanisms such as genetically determined arteriopathies. Neuroimaging confirmation of cerebrovascular disease in VaD provides information about the topography and severity of vascular lesions. Neuroimaging may also assist with the differential diagnosis of dementia associated with normal pressure hydrocephalus, chronic subdural hematoma, arteriovenous malformation or tumoral diseases. (orig.)

Assessment of cerebral circulation in normal fetuses by three-dimensional power Doppler ultrasonography

International Nuclear Information System (INIS)

Milani, Hérbene José Figuinha; Sá Barreto, Enoch Quinderé de; Araujo Júnior, Edward; Haratz, Karina Krajden; Rolo, Liliam Cristine; Nardozza, Luciano Marcondes Machado; Moron, Antonio Fernandes

2012-01-01

Objective: To assess the three-dimensional power Doppler ultrasonography (3D power Doppler) vascular indices in the middle cerebral artery (MCA), anterior cerebral artery (ACA) and posterior cerebral artery (PCA) territories. Methods: A cross-sectional study was carried out on 111 normal pregnancies between 26 and 34 weeks. The MCA, ACA and PCA territories closest to the transducer were scanned and volumes were calculated by using the VOCAL (Virtual Organ Computer-aided Analysis) program. The 3D power Doppler indices – vascularization index (VI), flow index (FI) and vascularization-flow index (VFI) were calculated. Scatter graphs, Pearson correlation coefficients (r) and linear regression models were used. Results: Only the FI-MCA (r = 0.38 and p < 0.001), VFI-MCA (r = 0.23 and p = 0.016) and FI-PCA (r = 0.191 and p = 0.040) had a low correlation with gestational age. The other 3D power Doppler indices VI-MCA (r = 0.153 and p = 0.150), VI-ACA (r = 0.105 and p = 0.271), FI-ACA (r = 0.154 and p = 0.106), VFI-ACA (r = 0.134 and p = 0.161), VI-PCA (r = 0.105 and p = 0.270) and VFI-PCA (r = 0.126 and p = 0.180) showed no statistically significant correlation with gestational. Conclusion: It was observed a low correlation between gestational age and the FI-MCA, VFI-MCA and FI-PCA.

The development of cerebral amyloid angiopathy in cerebral vessels. A review with illustrations based upon own investigated post mortem cases.

Science.gov (United States)

Mendel, T A; Wierzba-Bobrowicz, T; Lewandowska, E; Stępień, T; Szpak, G M

2013-12-01

The process of β-amyloid accumulation in cerebral vessels is presented. Cerebral amyloid angiopathy (CAA) was confirmed during an autopsy. It was diagnosed according to the Boston criteria. Cerebral amyloid angiopathy can involve all kinds of cerebral vessels (cortical and leptomeningeal arterioles, capillaries and veins). The development of CAA is a progressive process. β-amyloid appears first in the tunica media, surrounding smooth muscle cells, and in the adventitia. β-amyloid is progressively accumulated, causing a gradual loss of smooth muscle cells in the vessel wall and finally replacing them. Then, the detachment and delamination of the outer part of the tunica media results in the "double barrel" appearance, fibrinoid necrosis, and microaneurysm formation. Microbleeding with perivascular deposition of erythrocytes and blood breakdown products can also occur. β-amyloid can also be deposited in the surrounding of the affected vessels of the brain parenchyma, known as "dysphoric CAA". Ultrastructurally, when deposits of amyloid fibers were localized in or outside the arteriolar wall, the degenerating vascular smooth muscle cells were observed. In the Institute of Psychiatry and Neurology the study was carried out in a group of 48 patients who died due to intracerebral hemorrhage caused by sporadic CAA.

Caracterización de la enfermedad cerebrovascular isquémica en el servicio de medicina del hospital de Guanajay

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Silvio Acosta Tabares

2001-12-01

Full Text Available Se realizó un estudio de casos y controles con el objetivo de caracterizar clínica y epidemiológicamente la enfermedad cerebrovascular isquémica (ECVI. El grupo de casos estuvo constituido por 52 pacientes egresados con el diagnóstico de ictus isquémico, y el grupo control por igual número de pacientes que no la padecieron. Se determinó una prevalencia similar a la de otros estudios a escala mundial, con una incidencia mayor de la enfermedad en pacientes de 60 años y más, de la raza blanca y el sexo masculino. Los factores de riesgo con significación estadística fueron el sedentarismo, las dietas inadecuadas, el hábito de fumar y la hipercolesterolemia; la hipertensión arterial mostró fuerza de asociación tanto como antecedente familiar como personal con un 44,3 % para ambos. La trombosis cerebral fue la forma clínica predominante (63,5 %.A case-control study was conducted aimed at characterizing the ischemic cerebrovascular disease (ICVD clinical and epidemiologically. The group of cases was made up of 52 patients discharged with the diagnosis of ischemic ictus, whereas the control group was composed of the same number of patients who did not suffer from it. It was determined a prevalence similar to that of other studies at world scale, with a higher incidence of the disease among white male patients aged 60 and over. The risk factors with statistical significance were sedentarism, inadequate diets, smoking and hypercholesterolemia. Arterial hypertension showed force of association as a family and personal history with 44.3 % for both. Cerebral thrombosis was the prevailing clinical form (63.5 %.

Encefalopatías espongiformes transmisibles: enfermedad crónica desgastante

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M. A. Reyes-López

2006-01-01

Full Text Available Las enfermedades por encefalopatías espongiformes transmisibles (EET, algunas veces llamadas enfermedades “por priones”, son un grupo de enfermedades raras, incurables, neurodegenerativas y fatales, las cuales afectan a una variedad de mamíferos. En los pasados 20 años, las EET pasaron de ser “las enfermedades de fascinación” a enfermedades difíciles de entender, causantes de pérdidas económicas en el sector ganadero, además de provocar problemas de salud humana. Las EET incluyen Creutzfeldt-Jakob (CJD y kuru en humanos; scrapi en ovejas, encefalopatía en visón (TME y caquexia crónica del ciervo y alce (CWD. En el ganado, se propuso de manera sugestiva el nombre de “vacas locas” o encefalopatía espongiforme bovina (BSE. La CWD puede ser transmitida indirectamente a animales susceptibles a través de ambientes contaminados, mediante heces o cadáveres descompuestos. En los últimos 5 años, la distribución conocida de CWD en Norte América se extendió, incrementando las dudas sobre el impacto de esta enfermedad en cérvidos de vida libre y la viabilidad de ranchos cinegéticos. En México, no existe evidencia de CWD en venados de vida silvestre o cautiverio, aunque se ha detectado en un condado fronterizo de Nuevo México, EUA. La CWD es considerada una enfermedad exótica y deben de tomarse las medidas pertinentes para evitar su introducción en México.

U0126 attenuates cerebral vasoconstriction and improves long-term neurologic outcome after stroke in female rats

DEFF Research Database (Denmark)

Ahnstedt, Hilda; Mostajeran, Maryam; Blixt, Frank W

2015-01-01

, responses to this treatment in females and long-term effects on outcome are not known. Initial experiments used in vitro organ culture of cerebral arteries, confirming ERK1/2 activation and increased ETB receptor-mediated vasoconstriction in female cerebral arteries. Transient middle cerebral artery......-mediated contraction was studied with myograph and protein expression with immunohistochemistry. In vitro organ culture and tMCAO resulted in vascular ETB receptor upregulation and activation of ERK1/2 that was prevented by U0126. Although no effect on infarct size, U0126 improved the long-term neurologic function...

Caries temprana de infancia: ¿enfermedad infecciosa?

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F. Sandra Rojas, Dra.

2014-05-01

Full Text Available La caries dental es una de las enfermedades más comunes en la infancia y las personas continúan siendo susceptible a través de la vida. Aunque actualmente puede ser detenida y potencialmente revertida en etapas tempranas, no es autolimitada, progresa en forma crónica si no existe un cuidado y control de los factores que la producen, llegando a la destrucción de dientes, dolor, alteraciones funcionales, sistémicas y consecuencias en la calidad de vida de las personas. La caries temprana de infancia, de inicio precoz en niños, es causada en forma frecuente por hábitos alimenticios inapropiados y la adquisición temprana de microorganismos como Streptococcus mutans. Se ha sugerido una transmisión vertical de madre a hijo como la vía principal de adquisición de Streptococcus mutans, y también se ha demostrado en la literatura, que existiría una transmisión horizontal entre niños y sus cuidadores, compañeros de jardín infantil y colegios. Por esta razón durante muchos años se ha definido la enfermedad caries como infecciosa y transmisible. Nuevos avances en técnicas moleculares han dado evidencia acerca de la microflora autóctona y cómo la placa dental o biofilm funciona como un sistema ecológico dinámico y complejo. Existe evidencia que la caries dental no es una enfermedad infecciosa clásica, como se creía hace unos años, por el contrario, esta enfermedad es el resultado de un cambio ecológico en la biopelícula adquirida en la superficie dental. Además la transmisión de Streptococcus mutans de la madre hacia el hijo no implica que la enfermedad se desarrolle, por el contrario, la caries dental hoy se describe como una enfermedad común, compleja y multifactorial, donde interactúan varios factores de riesgo, entre los más destacados conductuales, ambientales y genéticos.

MRI in human immunodeficiency virus-associated cerebral vasculitis

International Nuclear Information System (INIS)

Berkefeld, J.; Lanfermann, H.

2000-01-01

Cerebral ischaemia caused by inflammatory vasculopathies has been described as complication of human immunodeficiency virus (HIV) infection. Imaging studies have shown ischaemic lesions and changes of the vascular lumen, but did not allow demonstration of abnormalities within the vessel wall itself. Two HIV-infected men presented with symptoms of a transient ischaemic attack. Initial MRI of the first showed no infarct; in the second two small lacunar lesions were detected. In both cases, multiplanar 3-mm slice contrast-enhanced T1-weighted images showed aneurysmal dilatation, with thickening and contrast enhancement of the wall of the internal carotid and middle cerebral (MCA) arteries. These findings were interpreted as indicating cerebral vasculitis. In the first patient the vasculopathy progressed to carotid artery occlusion, and he developed an infarct in the MCA territory, but then remained neurologically stable. In the second patient varicella zoster virus (VZV) infection was the probable cause of vasculitis. The clinical deficits and vasculitic MRI changes regressed with antiviral and immunosuppressive therapy. (orig.)

MRI in human immunodeficiency virus-associated cerebral vasculitis

Energy Technology Data Exchange (ETDEWEB)

Berkefeld, J.; Lanfermann, H. [Frankfurt Univ. (Germany). Abt. fuer Neuroradiologie; Enzensberger, W. [Klinik fuer Neurologie, Klinikum der Johann Wolfgang Goethe-Univ. Frankfurt am Main (Germany)

2000-07-01

Cerebral ischaemia caused by inflammatory vasculopathies has been described as complication of human immunodeficiency virus (HIV) infection. Imaging studies have shown ischaemic lesions and changes of the vascular lumen, but did not allow demonstration of abnormalities within the vessel wall itself. Two HIV-infected men presented with symptoms of a transient ischaemic attack. Initial MRI of the first showed no infarct; in the second two small lacunar lesions were detected. In both cases, multiplanar 3-mm slice contrast-enhanced T1-weighted images showed aneurysmal dilatation, with thickening and contrast enhancement of the wall of the internal carotid and middle cerebral (MCA) arteries. These findings were interpreted as indicating cerebral vasculitis. In the first patient the vasculopathy progressed to carotid artery occlusion, and he developed an infarct in the MCA territory, but then remained neurologically stable. In the second patient varicella zoster virus (VZV) infection was the probable cause of vasculitis. The clinical deficits and vasculitic MRI changes regressed with antiviral and immunosuppressive therapy. (orig.)

Arterial vascularization of the pineal gland.

Science.gov (United States)

Kahilogullari, Gokmen; Ugur, Hasan Caglar; Comert, Ayhan; Brohi, Recep Ali; Ozgural, Onur; Ozdemir, Mevci; Karahan, Suleyman Tuna

2013-10-01

The arterial vascularization of the pineal gland (PG) remains a debatable subject. This study aims to provide detailed information about the arterial vascularization of the PG. Thirty adult human brains were obtained from routine autopsies. Cerebral arteries were separately cannulated and injected with colored latex. The dissections were carried out using a surgical microscope. The diameters of the branches supplying the PG at their origin and vascularization areas of the branches of the arteries were investigated. The main artery of the PG was the lateral pineal artery, and it originated from the posterior circulation. The other arteries included the medial pineal artery from the posterior circulation and the rostral pineal artery mainly from the anterior circulation. Posteromedial choroidal artery was an important artery that branched to the PG. The arterial supply to the PG was studied comprehensively considering the debate and inadequacy of previously published studies on this issue available in the literature. This anatomical knowledge may be helpful for surgical treatment of pathologies of the PG, especially in children who develop more pathology in this region than adults.

Assessing regional cerebral blood flow in depression using 320-slice computed tomography.

Directory of Open Access Journals (Sweden)

Yiming Wang

Full Text Available While there is evidence that the development and course of major depressive disorder (MDD symptomatology is associated with vascular disease, and that there are changes in energy utilization in the disorder, the extent to which cerebral blood flow is changed in this condition is not clear. This study utilized a novel imaging technique previously used in coronary and stroke patients, 320-slice Computed-Tomography (CT, to assess regional cerebral blood flow (rCBF in those with MDD and examine the pattern of regional cerebral perfusion. Thirty nine participants with depressive symptoms (Hamilton Depression Rating Scale 24 (HAMD24 score > 20, and Self-Rating Depression Scale (SDS score > 53 and 41 healthy volunteers were studied. For all subjects, 3 ml of venous blood was collected to assess hematological parameters. Transcranial Doppler (TCD ultrasound was utilized to measure parameters of cerebral artery rCBFV and analyse the Pulsatility Index (PI. 16 subjects (8 =  MDD; 8 =  healthy also had rCBF measured in different cerebral artery regions using 320-slice CT. Differences among groups were analyzed using ANOVA and Pearson's tests were employed in our statistical analyses. Compared with the control group, whole blood viscosity (including high\\middle\\low shear rateand hematocrit (HCT were significantly increased in the MDD group. PI values in different cerebral artery regions and parameters of rCBFV in the cerebral arteries were decreased in depressive participants, and there was a positive relationship between rCBFV and the corresponding vascular rCBF in both gray and white matter. rCBF of the left gray matter was lower than that of the right in MDD. Major depression is characterized by a wide range of CBF impairments and prominent changes in gray matter blood flow. 320-slice CT appears to be a valid and promising tool for measuring rCBF, and could thus be employed in psychiatric settings for biomarker and treatment response purposes.

123I-IMP-SPECT in vascular dementia

International Nuclear Information System (INIS)

Namura, Yasuhiro; Miyoshi, Toshihiko; Shio, Hideo; Yamaguchi, Shinya; Kimura, Jun

1990-01-01

Cerebral blood flow (CBF) was studied by N-isopropyl-p- 123 I-iodoamphetamine (IMP)-single photon emission computed tomography (SPECT) in patients with vascular dementia. Patients were divided by CT/MRI findings into multiple or localized type and cortical or subcortical type. Of patients with multiple lesions in the cortex, the reduction of CBF was noted in several cortex corresponding to CT/MRI findings. Patients in this group had a high incidence of aphasia, agraphia, dyscalculia, and amnesia. Patients with multiple lesions in the white matter and basal ganglia were subdivided into 3 groups by clinical manifestations. CBF in those with dementia showed generalized reduction in all cerebral cortex and especially in bilateral frontal regions. CBF in those with slightly impaired mentality was almost normal. In another group with pseudobulbar palsy and/or extrapyramidal sings, CBF was reduced intermediately only in bilateral frontal regions. Typical symptoms in demented patients were apathy, emotional lability, and forgetfulness. In those with the localized type, CBF was reduced in cerebral cortical areas correlating with the impaired mental functions. (author)

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

Science.gov (United States)

Lutsey, Pamela L; Norby, Faye L; Gottesman, Rebecca F; Mosley, Thomas; MacLehose, Richard F; Punjabi, Naresh M; Shahar, Eyal; Jack, Clifford R; Alonso, Alvaro

2016-01-01

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

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

International Nuclear Information System (INIS)

Lee, Young Sik; Baek, Seung Yon; Rhee, Chung Sik; Kim, Hee Seup

1984-01-01

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

Cerebrovascular endothelin-1 hyper-reactivity is associated with transient receptor potential canonical channels 1 and 6 activation and delayed cerebral hypoperfusion after forebrain ischaemia in rats

DEFF Research Database (Denmark)

Johansson, S E; Andersen, X E D R; Hansen, R H

2015-01-01

. METHODS: Experimental forebrain ischaemia was induced in Wistar male rats by a two-vessel occlusion model, and the cerebral blood flow was measured by magnetic resonance imaging two days after reperfusion. In vitro vasoreactivity studies, immunofluorescence and quantitative PCR were performed on cerebral...... in the vascular smooth muscle cells was enhanced and correlated with decreased cerebral blood flow two days after forebrain ischaemia. Furthermore, under conditions when voltage-dependent calcium channels were inhibited, endothelin-1-induced cerebrovascular contraction was enhanced and this enhancement...... was presumably mediated by Ca(2+) influx via upregulated transient receptor potential canonical channels 1 and 6. CONCLUSIONS: Our data demonstrates that endothelin-1-mediated influx of extracellular Ca(2+) activates transient receptor potential canonical channels 1 and 6 in cerebral vascular smooth muscle cells...

Microcephalic osteodysplastic primordial dwarfism type II (MOPD II) with multiple vascular complications misdiagnosed as Dubowitz syndrome

OpenAIRE

Dieks, Jana-Katharina; Baumer, Alessandra; Wilichowski, Ekkehard; Rauch, Anita; Sigler, Matthias

2014-01-01

To date, the genetic basis of Dubowitz syndrome (short stature, microcephaly, facial abnormalities, eczema) is unknown and vascular complications are not known to be associated with this syndrome. In microcephalic osteodysplastic primordial dwarfism type II (MOPD II; disproportionate short statue, microcephaly, facial abnormalities), however, cerebral aneurysms and other vascular abnormalities are frequent complications. MOPD II is a genetic disorder caused by mutations in the pericentrin (PC...

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

OpenAIRE

Fonseca,Luiz Henrique de Oliveira; Rosa,Maria Luiza Garcia; Silva,Arthur Carvalho; Maciel,Renan Marchesi; Volschan,André; Mesquita,Evandro Tinoco

2013-01-01

O acidente vascular cerebral isquêmico (AVCi) é uma importante causa de sequela e morte. A correta utilização do trombolítico enfrenta várias barreiras. O objetivo foi discutir as barreiras à terapia trombolítica em pacientes que chegam, com sintomas de AVCi agudo, à emergência de um hospital privado do Rio de Janeiro, Brasil. Coorte retrospectiva de pacientes entre 2009 e 2011. Foram admitidos 257 pacientes com suspeita de AVCi. Dos pacientes com diagnóstico confirmado (156), 11,5% (18) fora...

Evaluation of cerebral blood flow, cerebral metabolism and cerebral function by magnetic resonance imaging

International Nuclear Information System (INIS)

Tanaka, Chuzo; Higuchi, Toshihiro; Umeda, Masahiro; Naruse, Shoji; Horikawa, Yoshiharu; Ueda, Satoshi; Furuya, Seiichi.

1995-01-01

The magnetic resonance (MR) method has the unique potentiality of detecting cerebral metabolites, cerebral blood flow and brain functions in a noninvasive fashion. We have developed several MR techniques to detect these cerebral parameters with the use of clinical MRI scanners. By modifying the MR spectroscopy (MRS) technique, both 31 P- and 1 H-MRS data can be obtained from multiple, localized regions (multi-voxel method) of the brain, and the distribution of each metabolite in the brain can be readily visualized by metabolite mapping. The use of diffusion weighted images (DWI) permits visualization of the anisotropy of water diffusion in white matter, and based on the difference of diffusion coefficiency, the differential diagnosis between epidermoid tumor and arachnoid cyst can be made. By employing dynamic-MRI (Dyn-MRI) with Gd-DTPA administration, it is possible to examine the difference in blood circulation between brain tumor tissue and normal tissue, as well as among different types of brain tumors. By using magnetization transfer contrast (MTC) imaging, it has become possible to detect brain tumors, and with a small dose of Gd-DTPA, to visualize the vascular system. Functional MRI (fMRI) visualizes the activated brain by using conventional gradient echo technique on conventional MRI scanners. This method has the unique characteristic of detecting a brain function with high spatial and temporal resolution by using the intrinsic substance. Moreover, the localization of motor and sensory areas was detected by noninvasive means within few minutes. The fMRI procedure will be used in the future to analyze the higher and complex brain functions. In conclusion, multi-modality MR is a powerful technique that is useful for investigating the pathogenesis of many diseases, and provides a noninvasive analytic modality for studying brain function. (author)

Transcephalic electrical impedance in the study of cerebral circulation in a juvenile pig model.

Science.gov (United States)

Grönlund, J; Bartocci, M; Kääpä, P; Jahnukainen, T; Rautanen, M; Halkola, L; Välimäki, I

1997-11-01

Transcephalic electrical impedance offers a technique for non-invasive, cot-side monitoring of neonatal cerebral circulation but the exact nature of the signal is somewhat ambiguous. The impedance signal is examined in an animal project where the ventilator settings are adjusted (20 min-1-10 min-1-40 min-1 for 10 min periods each) to produce circulatory changes. Six juvenile pigs are intubated, and ECG, arterial blood pressure, carotid flow (CF) by electromagnetic flowmeter and impedance are continuously monitored and stored on analogue tape. Cardiac output by thermodilution, blood oxygen (pO2) and carbon dioxide (pCO2) tensions are measured. ECG is converted to heart rate, mean blood pressure is integrated, and the high-frequency (1.50-4.00 Hz) component of the impedance signal delta Z is computed using autoregressive spectral estimation. Stroke volume, peripheral vascular resistance (PVR) and cerebral vascular resistance (CVR) are calculated. pCO2 and CF increase and pO2 decreases during hypoventilation. CF correlates positively with cardiac output, stroke volume, delta Z and pCO2, and negatively with pO2 and CVR. delta Z correlates positively with heart rate and cardiac output, and negatively with PVR and CVR. It is concluded that the impedance signal is related to the amount of blood transmitted to the brain by every beat of the heart, depending on the changes in both the systemic circulation and the cerebral vascular compliance.

Terapia baseada em realidade virtual usando o leap motion controller para reabilitação do membro superior após acidente vascular cerebral = Virtual reality therapy using the leap motion controller for post-stroke upper limb rehabilitation Virtual reality therapy using the Leap Motion Controller for post-stroke upper limb rehabilitation

Directory of Open Access Journals (Sweden)

Soares, Nayron Medeiros

2017-01-01

Full Text Available OBJETIVOS: Avaliar a aplicabilidade de um sensor de movimento, baseado em realidade virtual, para promover a reabilitação do membro superior após um acidente vascular cerebral. RELATO DOS CASOS: Três pacientes após acidente vascular cerebral realizaram um treino para reabilitação do membro superior com realidade virtual usando a tecnologia Leap Motion Controller e o jogo Playground 3D®, durante três dias consecutivos. No primeiro e no terceiro dia, foram avaliados com os testes Caixa e Blocos, Coordenação Óculo-Manual de Melo e Estimulação Magnética Transcraniana. No último dia, foram aplicadas Fichas de Avaliação da Experiência do paciente. Após o treinamento proposto, observou-se diminuição do limiar motor em ambos os hemisférios cerebrais e melhores desempenhos nos testes que avaliaram a habilidade manual e óculo-manual. A terapia proposta foi bem recebida pelos pacientes testados. CONCLUSÕES: Não foram observados efeitos adversos e os resultados mostram-se promissores e precisos no treinamento realizado com realidade virtual usando a tecnologia Leap Motion Controller e o jogo Playground 3D®. O treinamento proporcionou uma participação ativa dos pacientes na reabilitação das sequelas de extremidade superior após um acidente vascular cerebral

Estado de las enfermedades raras que cursan con discapacidad intelectual en Colombia

OpenAIRE

Hurtado Sánchez, Johan Sebastián

2016-01-01

Las enfermedades raras o huérfano son una problemática que ha tomado mucha importancia en el contexto mundial del presente siglo, estas se han definido como crónicas, de difícil tratamiento de sus síntomas y con baja prevalencia en la población; muchas de estas enfermedades cursan con varios tipos de discapacidad, siendo el objetivo del presente trabajo el enfocarse en aquellas enfermedades raras que cursan con discapacidad intelectual. Para poder profundizar en estas enfermedades se realizó ...

[The magneto-, photo- and laser therapy of headaches in patients with vascular brain lesions].

Science.gov (United States)

Troshin, V D; Miasnikov, I G; Belousova, T E

1994-01-01

To manage vascular cephalalgia, a combined approach is proposed: segmentally oriented magnetic, photo- and photomagnetic therapy plus intravenous laser treatment. The effect was directly correlated with cerebral hemodynamic condition, damage to vegetative innervation segmental-peripheral link and physiotherapeutic factors.

l-arginine and l-NMMA for assessing cerebral endothelial dysfunction in ischaemic cerebrovascular disease

DEFF Research Database (Denmark)

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 NG -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...... 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....

Enfermedad Diverticular del Colon

Directory of Open Access Journals (Sweden)

Gonzalo López Escobar

1991-06-01

Full Text Available

Los divertículos del colon han sido reconocidos por varios observadores desde hace más de un siglo, pero en su mayor parte se trataba de casos aislados, hoy se la considera como la enfermedad del siglo XX, la de la era moderna y de los países industrializados y de avanzada tecnología (5,18,33.

Según el diccionario de la Real Academia Española (11, divertículo, del latín, diverticulum, quiere decir desviación de un camino; y desde el punto de vista anatómico, apéndice hueco y terminado en fondo de saco. (Gráfica No. 1.

Goligher (17 lo define como la “posada al borde del camino, probablemente un lugar, a menudo, de mala reputación”.

Historia

Según Hackford (18, el proceso fué descrito brevemente por Littre a comienzos del siglo XVIII; pero se le atribuye a Cruveilhier la primera descripción como proceso patológico en 1849, quien, además, mencionó: “encontramos, no rara vez, en el sigmoide, entre las bandas de fibras musculares longitudinales, una serie de pequeños tumores piriformes oscuros, que están formados por hernias de la mucosa a través de brechas en la capa muscular” (17.

Fleischman en 1815 hizo la primera observación de la enfermedad y empleó el término divertículo (45.

Rokitansky en 1.849, habló de una enfermedad adquirida y consideró que su causa consistía en la constipación (45.

Virchowen 1853 describió la perisigmoiditis (45.

En 1859 Sidney Jones informó de una fístula colo-vesical debida a diverticulitis (5,45.

Loomis en 1870 describe una peritonitis como resultante de una diverticulitis (45.

En 1877 Ball describió la anatomía patológica de la enfermedad y presentó dos casos de fístula colovesical debidas a diverticulitis (9. Cripps en 1.888 popularizó la colostomía de desviación como tratamiento para la fístula colovesical(18...

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

OpenAIRE

Zirak P.; Delgado-Mederos R.; Marti-Fabregas J.; Durduran T.

2010-01-01

Acetazolamide (ACZ) was used to stimulate the cerebral vasculature on ten healthy volunteers to assess the cerebral vasomotor reactivity (CVR). We have combined near infrared spectroscopy (NIRS), diffuse correlation spectroscopy (DCS) and transcranial Doppler (TCD) technologies to non-invasively assess CVR in real-time by measuring oxy- and deoxy-hemoglobin concentrations, using NIRS, local cerebral blood flow (CBF), using DCS, and blood flow velocity (CBFV) in the middle cerebral artery, usi...

Functional Magnetic Resonance Imaging in the Presurgical Evaluation of Brain Vascular Malformations

International Nuclear Information System (INIS)

Montes, Natalia; Herrera, Diego A; Vargas Sergio A

2010-01-01

Objective: To describe our experience in presurgical evaluation of intracranial vascular malformations by means of functional magnetic resonance (fMRI). Method: To evaluate eight patients with cerebral vascular malformations (seven arterio-venous malformation [AVM ] and one cavernous malformation) to send to the eloquent cortex with RMf pre-surgical mapping is assessed. Used a technique that is dependent on the level of oxygen (BOLD) to locate these areas in the cerebral vascular malformation, by applying different paradigms. Results: We found one AVM at the right temporal lobe with activation of the parahipocampal gyrus at the contralateral side using a memory paradigm; another patient with an AVM at the right mesotemporal lobe showed activation of visual and spatial memory of the contralateral hippocampus and parahippocampus. One patient with an AVM at the left parietal lobe without compromise of sensorial and motor cortex; a cavernous malformation at the left angular gyrus with hemispheric language dominance in that side; one right thalamic AVM, one periventricular AVM bilateral language dominance; one left occipital AVM with decreased activation in visual association cortex; one temporoccipital AVM with left language dominance and neurovascular uncoupling. Conclusion: fMRI can delineate anatomically the relationship between the lesion and eloquent cortex, providing useful information for presurgical planning and allowing risk estimation of intervention.

A study of cerebral circulation, metabolism and MRI findings in patients with chronic cerebral circulatory insufficiency

International Nuclear Information System (INIS)

Kondo, Susumu

1995-01-01

Chronic cerebral circulatory insufficiency (CCCI) is a recently proposed clinical entity characterized by symptoms such as dizziness, a feeling of heavy-headedness or vague numbness without any neurological signs or organic vascular lesions on CT. In order to elucidate its pathogenesis, ultrasonic quantitative blood flow measurement system, positron emission tomography (PET) and MRI were employed to study three groups of subjects: 60 subjects with CCCI (group A), 44 subjects with risk factors for cerebrovascular disease but without neurological abnormalities (group B), and 40 normal healthy volunteers (group C). The results are summarized as follows: Mean common carotid blood flow decreased with age in all groups. Common carotid blood flow was lowest in group A and second lowest in group B in every decade of patient age. PET study revealed that CBF and CMRO 2 in all regions examined were significantly lower in group A than in group C. The incidence of MR signal abnormalities in the white matter increased with age. Group A had the highest incidence, and group C had the lowest. Reduction in mean common carotid blood flow and cerebral blood flow was associated with increasing incidence and severity of MR signal abnormalities. These findings indicate that CCCI is a pathologic condition closely related to diffuse cerebral low perfusion resulting from cerebral arteriosclerosis. The symptoms seen in this condition, which are apt to be taken lightly, may warn of impending ischemic stroke. (author)

La enfermedad de Alzheimer y los inhibidores de la colinesterasa

OpenAIRE

Carlos Luis Alpízar-Quesada; Catalina Morales-Alpízar

2003-01-01

La enfermedad de alzheimer (EA), es muy frecuente en la vejez donde se pierden, en forma lenta y progresiva, capacidades cognoscitivas y motoras. Esta enfermedad ha ido en aumento conforme se incrementa la expectativa de vida de la población. En los últimos años, descubrir un tratamiento efectivo para esta enfermedad ha sido un verdadero reto científico. A pesar de que su patología fue descrita hace algunos años, no hubo tratamiento disponible hasta hace poco tiempo. Desde principios de los n...

[Neuroradiological pattern of peripartum cerebro vascular disease medicating transfer to determine care unit].

Science.gov (United States)

Lakhdar, Rim; Baffoun, Nader; Hammami, Nadia; Nagi, Sonia; Baccar, Kamel; Drissi, Syrine; Kaddour, Chokri

2012-03-01

Pregnancy and puerperium are considered a period of a high risk of stroke responsible in a part of the morbidity and mortality in women. Imaging is the pivotal tool to diagnostics and care. To investigate the clinical and imaging features cerebrovascular complications during pregnancy and in post partum period. We report a retrospective analysis of forty four patients (November 2002 - October 2010) admitted in the intensive car department of the national institute of neurology for cerebro-vascular complications during pregnancy and in post partum period. Cerebro-vascular imaging modalities included cerebral computed tomography (CCT) with and without contrast in 94% of cases, magnetic resonance imaging (MRI) in 30.6% of cases completed by venous angiography MRI in 27.2% of cases and angiography MRI of Willis polygon in 11.3% of cases and by cerebral angiography in 13.6% of cases. Posterior reversible encephalopathy syndrome (PRES) is diagnosed in 61.4 % of cases followed by meningo-cerebral haemorrhage (MCH) in 29.5% and finally cerebral venous thrombosis (CVT) and arterial ischemia in 4.5% of cases each one. The cerebro-vascular complications are revelled in 86.3 % of the cases during the postpartum and were associated with the eclampsia or preeclampsia in 90.9 % of the cases (n=40). CCT showed typical lesions of PRES in 23 patients. It confirms the presence of hematoma in the 13 patients with MCH and find hypodense lesion in one case with ischemic stroke. CCT show direct (delta sign) and indirect signs of CVT. MRI confirms the diagnostic of PRES, when done (11 of 12 cases) and show cortical sub cortical hyper signal on T2 and FLAIR and hypo signal on T1 sequences. MRI was normal in one case. It shows hemorrhagic lesion in the 2 cases of MCH, thrombosis in the cases of CVT and ischemic lesion in the cases of ischemic stroke. CCT and MRI done within 48 hours from admission were decisive for early diagnostic and for fast and adequate care. Early recognition of stroke

Tratamiento de la enfermedad de Graves Basedow

OpenAIRE

Hernando Vargas-Uricoechea; Carlos Hernán Sierra-Torres; Ivonne Alejandra Meza-Cabrera

2014-01-01

Se realizó una revisión narrativa rigurosa de la literatura inglesa y en español sobre diferentes aspectos de la Enfermedad de Graves-Basedow e hipertiroidismo. Esta patología –parte de la llamada “enfermedad tiroidea autoinmune”- se produce como consecuencia de la presencia de anticuerpos circulantes que se unen y activan al receptor de tirotropina, desencadenándose generalmente el hipertiroidismo en asociación con un estrés agudo. En este artículo actualizamos tanto el manejo de hipertiroid...

Disfagia asociada a la enfermedad de Parkinson

OpenAIRE

Rodríguez Alonso, Alexandra

2017-01-01

La disfagia orofaríngea es un síntoma que se asocia a la enfermedad de Parkinson, se define como la dificultad o el impedimento al avance normal del bolo alimenticio desde la cavidad oral hasta el estómago, contribuyendo a una deglución ineficaz e insegura. Este proyecto de investigación tiene como objetivo principal detectar disfagia en pacientes con Enfermedad de Parkinson. Se realizó una encuesta que fue distribuida entre los EP que acuden a rehabilitación a la Asociación de Parkinson V...

Cerebral microbleeds in a neonatal rat model.

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Brianna Carusillo Theriault

Full Text Available In adult humans, cerebral microbleeds play important roles in neurodegenerative diseases but in neonates, the consequences of cerebral microbleeds are unknown. In rats, a single pro-angiogenic stimulus in utero predisposes to cerebral microbleeds after birth at term, a time when late oligodendrocyte progenitors (pre-oligodendrocytes dominate in the rat brain. We hypothesized that two independent pro-angiogenic stimuli in utero would be associated with a high likelihood of perinatal microbleeds that would be severely damaging to white matter.Pregnant Wistar rats were subjected to intrauterine ischemia (IUI and low-dose maternal lipopolysaccharide (mLPS at embryonic day (E 19. Pups were born vaginally or abdominally at E21-22. Brains were evaluated for angiogenic markers, microhemorrhages, myelination and axonal development. Neurological function was assessed out to 6 weeks.mRNA (Vegf, Cd31, Mmp2, Mmp9, Timp1, Timp2 and protein (CD31, MMP2, MMP9 for angiogenic markers, in situ proteolytic activity, and collagen IV immunoreactivity were altered, consistent with an angiogenic response. Vaginally delivered pups exposed to prenatal IUI+mLPS had spontaneous cerebral microbleeds, abnormal neurological function, and dysmorphic, hypomyelinated white matter and axonopathy. Pups exposed to the same pro-angiogenic stimuli in utero but delivered abdominally had minimal cerebral microbleeds, preserved myelination and axonal development, and neurological function similar to naïve controls.In rats, pro-angiogenic stimuli in utero can predispose to vascular fragility and lead to cerebral microbleeds. The study of microbleeds in the neonatal rat brain at full gestation may give insights into the consequences of microbleeds in human preterm infants during critical periods of white matter development.

Study on the change and relationship between plasma D-dimer and homocysteine levels in patients with acute cerebral vascular accident

International Nuclear Information System (INIS)

Lu Ye; Pan Xiangtao; Yan Min

2009-01-01

Objective: To study the clinical significance of the changes and the relationships between plasma D-dimer (D-D) and Homocysteine (Hcy) expression in patients with acute cerebral infarction and acute cerebral hemorrhage. Methods: Plasma D-D (with ELISA) and Hcy (with CLIA) levels were measured in 397 patients with cerebral infarction, 122 patients with cerebral hemorrhage and 30 controls.Results 1) The mean level of the plasma D-D and Hcy in patients with acute cerebral infarction was 5.20±0.92μg/L and 21.23±13.54 μmol/L respectively, which was significant higher than that in controls and patients with acute cerebral hemorrhage. 2) Higher expressing of D-D and Hcy was found in 101 (25.4%) and 140 (35.3%) cases of acute cerebral infarction patients. The data in acute cerebral hemorrhage group was 17 (13.9%) and 27 (22.1%) respectively. There was significant difference between two groups, P<0.01. 3) There was not correlations with the expression level of D-D and Hcy in patients with acute cerebral infarction and patients with acute cerebral hemorrhage. 4) The expressing level of the Plasma D-D in acute cerebral infarction patients was not significant difference in both age and sex. The expressing level of Hcy in male was higher than that in female. There was not significant difference in the expressing level of Hcy in different age. Conclusion: The levels of plasma D-D and Hcy in patients with acute cerebral infarction significantly in creased, but there were not correlations between the levels of the two parameters. (authors)

Egas Moniz: 90 Years (1927-2017) from Cerebral Angiography.

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Artico, Marco; Spoletini, Marialuisa; Fumagalli, Lorenzo; Biagioni, Francesca; Ryskalin, Larisa; Fornai, Francesco; Salvati, Maurizio; Frati, Alessandro; Pastore, Francesco Saverio; Taurone, Samanta

2017-01-01

In June 2017 we celebrate the 90th anniversary of the pioneer discovery of cerebral angiography, the seminal imaging technique used for visualizing cerebral blood vessels and vascular alterations as well as other intracranial disorders. Egas Moniz (1874-1955) was the first to describe the use of this revolutionary technique which, until 1975 (when computed tomography, CT, scan was introduced in the clinical practice), was the sole diagnostic tool to provide an imaging of cerebral vessels and therefore alterations due to intracranial pathology. Moniz introduced in the clinical practice this fundamental and important diagnostic tool. The present contribution wishes to pay a tribute to the Portuguese neurosurgeon, who was also a distinguished neurologist and statesman. Despite his tremendous contribution in modern brain imaging, Egas Moniz was awarded the Nobel Prize in Physiology or Medicine in 1949 for prefrontal leucotomy, the neurosurgical intervention nowadays unacceptable, but should rather be remembered for his key contribution to modern brain imaging.

Clinical and imaging characteristics of the vascular dementia. Preliminary studies

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Gomez Viera, Nelson; Rivero Arias, Edmundo; Perez Nellar, Jesus; Begueria Santos, Ramon; Arias Sifontes, William; Raiteris Flores, Juan

1997-01-01

A descriptive prospective study was carried out in 41 patients presenting with vascular dementia from Habana Vieja municipality, Havana City, in order to know some of the clinical and imaging characteristics of this disease. The main risk factors observed were the history of cerebrovascular disease and arterial hypertension. Depression, sleeping disorders and focal and pseudo bulbar neurologic signs were the most frequent clinical findings. Folstein neuropsychological test evidenced an important disorder of attention, calculation, the evocation memory and orientation. According to this test, 29 % of the patients had a severe dementia and nearly 50 % showed a severe handicap. The most frequent imaging findings observed in the computerized axial tomography of the cranium were cerebral atrophy, and single or multiple infarctions. Multiple cerebral infarctions, the lacunar status, subcortical encephalopathy of Binswanger, and single infarction located in cerebral areas related to cognition were considered as possible psychopathological mechanisms associated with the disease

El timerosal y las enfermedades del neurodesarrollo infantil

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Luis Maya

2006-09-01

Full Text Available Se evalúa la relación causal entre el timerosal (etilmercurio, como preservante en las vacunas pediátricas, y el incremento de casos de enfermedades del neurodesarrollo infantil, como consecuencia de la ampliación de los esquemas de inmunización. Se revisó la información científica, relacionando el timerosal y las evidencias que permitan evaluar una posible asociación causal, con estudios epidemiológicos, ecológicos, biomoleculares y toxicológicos, de bioseguridad, toxicológicos fetales y sobre salud reproductiva. Se encontró múltiples asociaciones entre la exposición a timerosal y las enfermedades del neurodesarrollo infantil. Tal neurotoxicidad ocurre en los infantes y fetos de gestantes vacunadas por dosis acumulativa de mercurio. Las diversas evidencias implican al timerosal como el agente causante, agravante o disparador de las enfermedades del neurodesarrollo infantil. La toxicidad del mercurio obligó al retiro progresivo del timerosal de los medicamentos. Lamentablemente, en las vacunas, ha habido una sustancial demora en la demostración de su impacto negativo. Actualmente, existen vacunas sin timerosal, cuyo uso está ocasionando la disminución de la incidencia de las enfermedades del neurodesarrollo infantil.

Enfermedad, lenguaje y vida animal

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Miguel Martínez García

2017-07-01

Full Text Available En este artículo planteamos una aproximación crítica a la «cuestión animal» desde la perspectiva de la enfermedad. El problema de la «animalidad», en efecto, y de su relación con lo humano, constituye un problema clave en las experiencias modernas de «lo patológico». Es frecuente, ciertamente, que en un contexto de enfermedad grave o ante un proceso patológico agudo se produzca un efecto de acercamiento o de asimilación entre el sujeto enfermo y el animal. En la mayoría de los casos, dicha animalización está íntimamente relacionada con el discurso y la práctica médica. Sin embargo, creemos que «lo animal» está irrumpiendo también de otro modo en nuestras experiencias de enfermedad. Para entender esta irrupción, creemos que es adecuado volver a recurrir a la idea del «devenir animal» de Deleuze. Con esta herramienta, nos enfrentamos a un corpus de textos literarios recientes en los se aprecia un «devenir animal» del enfermo que contesta a los procesos de animalización ligados a la clínica. El «devenir animal» del enfermo se materializa específicamente, en estos casos, en relación con un particular «devenir animal de la lengua».

Errores innatos del metabolismo: Enfermedades lisosomales

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Caridad Menéndez Saínz

2002-03-01

Full Text Available Dentro de los errores innatos del metabolismo se encuentran las enfermedades de almacenamiento lisosomal o enzimopatías lisosomales, las cuáles se caracterizan por un déficit enzimático específico, la excreción de metabolitos por la orina y la acumulación de los compuestos no degradados en diferentes órganos y tejidos que ocasionan la disfución de éstos. Tienen un patrón de herencia autosómico recesivo, excepto para la enfermedad de Fabry y la enfermedad de Hunter en las que el patrón de herencia está ligado al cromosoma X. Estas enfermedades tienen una baja incidencia en general, aunque hay poblaciones donde algunas de ellas tienen una alta incidencia. Su importancia radica en la magnitud que representan como problema de salud, por la pobre calidad de vida de esos pacientes, así como su fallecimiento prematuro, motivo por el cual hay que evitar los nacimientos de nuevos niños afectados.Among the metabolism inborn errors, there are the lysosomal storage diseases or lysosomal enzymopathies that are characterized by an specific enzymatic deficiency, excretion of metabollites in urine and accumulation of non-degraded compounds in various organs and tissues causing their dysfunction. These diseases have a recessive autosomal heredity, except for Fabry´s disease and Hunter’s disease in which the pattern of heredity is chromosome X-linked. These diseases have a low incidence in general although there are populations where they show a high incidence. Their importance lies in what they represent as a health problem because of the poor quality of life of these patients and their early death, therefore, it is necessary to prevent the birth of new infants affected with these diseases.

PREVALENCIA Y MORTALIDAD DE LA ENFERMEDAD DE HUNTINGTON A PARTIR DEL REGISTRO POBLACIONAL DE ENFERMEDADES RARAS DE LAS ISLAS BALEARES DURANTE EL PERÍODO 2010-2013

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Mercedes Cáffaro Rovira

2017-01-01

Full Text Available La enfermedad de Huntington (EH es una enfermedad hereditaria de baja prevalencia, por lo que se incluye en los registros de enfermedades raras. El registro poblacional de enfermedades raras de las Islas Baleares se inició en el año 2010. Previamente no existían datos de prevalencia y mortalidad de la EH en las Islas Baleares. El objetivo de este estudio fue determinar la prevalencia y la mortalidad de la enfermedad de Huntington en las Islas Baleares durante el periodo 2010-2013. Métodos: Se utilizaron como fuentes de información el registro poblacional de enfermedades raras de las Islas Baleares, del que se obtuvieron los casos diagnosticados, el Registro de mortalidad de las Islas Baleares, del que se obtuvieron los casos fallecidos, el registro del Servicio de Salud de las Islas Baleares del que se obtuvieron el número de tarjetas sanitarias y del Instituto Nacional de Estadística se obtuvieron los datos de población. Se calcularon las tasas de prevalencia y de mortalidad. Resultados: El registro poblacional de enfermedades raras de las Islas Baleares durante el periodo 2010-2013 registró 27 casos de EH. El 63% fueron mujeres. La tasa de prevalencia fue de 2,6 por 105 y la tasa de mortalidad de 1,1 por 105. La isla de Menorca fue la más afectada con una prevalencia de 5,9 por 105 y una mortalidad de 2,1 por 105. Conclusiones: La prevalencia y mortalidad de la EH en las Islas Baleares son bajas en comparación con zonas del entorno.

La legionelosis como enfermedad profesional: metodología de valoración

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Marta Dorronsoro Dorronsoro

2014-06-01

Full Text Available La Legionella es una enfermedad bacteriana producida por la Legionella Pneumofila, patógeno oportunista que para causar una enfermedad debe estar presente en el lugar (reservorio, debe alcanzar un número suficiente para causar la infección (amplificación y debe pasar al ambiente en estado infectivo (diseminación los focos de contaminación que con mayor frecuencia han sido relacionados con los brotes epidémicos son instalaciones de suministro de agua y de acondicionamiento del aire de los edificios como: circuitos de distribución de agua caliente sanitaria, sistemas de climatización, aguas termales de centros de rehabilitación y recreo, equipos de aerosolterapia. El desarrollo de la enfermedad depende de la exposición al microorganismo patógeno, de la virulencia y de la inmunidad del huésped. La enfermedad puede ser asumida como enfermedad profesional cuando su aparición va ligada a la exposición al agente patógeno, demostrada su presencia en el medio de trabajo y realizando tareas en las que es posible su infección. En este artículo a propósito de un caso se establecen los pasos para la determinación de la contingencia profesional de una enfermedad causada por exposición a agentes biológicos Material y método: Se han revisado hasta mayo de 2013 las siguientes bases de datos bibliográficas: SciELO, y PUBMED. Así como la Bibliografía y documentos de consulta citados en la misma Conclusiones: la neumonía por legionella puede contraerse tanto con carácter ocupacional ligado al trabajo como ambiental. Como toda enfermedad profesional, la diferencia no está en los signos o síntomas de la enfermedad, que no difieren en la neumonía por legionella ni en la clínica ni en la analítica, ni en las pruebas de imagen en cuanto al origen causal, sea este ambiental o de ocio o en la práctica laboral, sino que su adscripción diferencial causal ligada al trabajo viene definida por cumplir con los requisitos legales que dotan a

ENFERMEDAD, MUERTE Y MEMORIA LA EXPERIENCIA FUNERARIA COMO INSTANCIA DEL RECUERDO (UNA LECTURA DE LA ENFERMEDAD, DE ALBERTO BARRERA TYSZKA

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José Javier Franco

2016-01-01

Full Text Available Experiencia y memoria dicen de una vida en común; ambas son, esencialmente, colectivas. Vivir y recordar nos comprometen con el otro, porque incluso la experiencia más íntima está mediada por su presencia; o por su ausencia, que es otra forma de estar juntos. La muerte augura no sólo el fin de la experiencia, sino también su carácter irrecuperable, irreversible. La enfermedad es el aviso, la antesala de la muerte. Enfermedad y muerte convocan el pasado, lo instan a hacerse (en el presente, aunque toda restitución sea imposible. Pero la muerte, al menos la propia, es inenarrable. No hay un discurso pos mortem que no provenga del otro, de los otros. La enfermedad y la muerte del prójimo, del otro próximo, activan la memoria y el discurso funerarios. Los vivos recuerdan al muerto y hablan en su nombre. La enfermedad, de Alberto Barrera Tyszka, ficciona ese doble proceso de recordación y pérdida: la muerte del padre signa no sólo el pasado, sino el futuro del hijo, que ve en el presente tanto la repetición traumática del pasado, como el proceso de duelo que inaugura. Estas líneas proponen una lectura de esa puesta en escena.

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

International Nuclear Information System (INIS)

Chang, Kee Hyun; Chung, Jin Wook; Han, Moon Hee; Kang, Heung Sik; Han, Man Chung; Kim, Chu Wan

1989-01-01

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

Tuberculosis como enfermedad ocupacional Tuberculosis as occupational disease

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Alberto Mendoza-Ticona

2012-01-01

Existe evidencia suficiente para declarar a la tuberculosis como enfermedad ocupacional en diversos profesionales especialmente entre los trabajadores de salud. En el Perú están normados y reglamentados los derechos laborales inherentes a la tuberculosis como enfermedad ocupacional, como la cobertura por discapacidad temporal o permanente. Sin embargo, estos derechos aún no han sido suficientemente socializados. En este trabajo se presenta información sobre el riesgo de adquirir tuberculosis ...

sup 123 I-IMP-SPECT in vascular dementia

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Namura, Yasuhiro; Miyoshi, Toshihiko; Shio, Hideo; Yamaguchi, Shinya; Kimura, Jun (Kyoto Univ. (Japan). Hospital)

1990-12-01

Cerebral blood flow (CBF) was studied by N-isopropyl-p-{sup 123}I-iodoamphetamine (IMP)-single photon emission computed tomography (SPECT) in patients with vascular dementia. Patients were divided by CT/MRI findings into multiple or localized type and cortical or subcortical type. Of patients with multiple lesions in the cortex, the reduction of CBF was noted in several cortex corresponding to CT/MRI findings. Patients in this group had a high incidence of aphasia, agraphia, dyscalculia, and amnesia. Patients with multiple lesions in the white matter and basal ganglia were subdivided into 3 groups by clinical manifestations. CBF in those with dementia showed generalized reduction in all cerebral cortex and especially in bilateral frontal regions. CBF in those with slightly impaired mentality was almost normal. In another group with pseudobulbar palsy and/or extrapyramidal sings, CBF was reduced intermediately only in bilateral frontal regions. Typical symptoms in demented patients were apathy, emotional lability, and forgetfulness. In those with the localized type, CBF was reduced in cerebral cortical areas correlating with the impaired mental functions. (author).

Enhanced expressions of microvascular smooth muscle receptors after focal cerebral ischemia occur via the MAPK MEK/ERK pathway

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Edvinsson Lars

2008-09-01

Full Text Available Abstract Background MEK1/2 is a serine/threonine protein that phosphorylates extracellular signal-regulated kinase (ERK1/2. Cerebral ischemia results in enhanced expression of cerebrovascular contractile receptors in the middle cerebral artery (MCA leading to the ischemic region. Here we explored the role of the MEK/ERK pathway in receptor expression following ischemic brain injury using the specific MEK1 inhibitor U0126. Methods and result Rats were subjected to a 2-h middle cerebral artery occlusion (MCAO followed by reperfusion for 48-h and the ischemic area was calculated. The expression of phosphorylated ERK1/2 and Elk-1, and of endothelin ETA and ETB, angiotensin AT1, and 5-hydroxytryptamine 5-HT1B receptors were analyzed with immunohistochemistry using confocal microscopy in cerebral arteries, microvessels and in brain tissue. The expression of endothelin ETB receptor was analyzed by quantitative Western blot. We demonstrate that there is an increase in the number of contractile smooth muscle receptors in the MCA and in micro- vessels within the ischemic region. The enhanced expression occurs in the smooth muscle cells as verified by co-localization studies. This receptor upregulation is furthermore associated with enhanced expression of pERK1/2 and of transcription factor pElk-1 in the vascular smooth muscle cells. Blockade of transcription with the MEK1 inhibitor U0126, given at the onset of reperfusion or as late as 6 hours after the insult, reduced transcription (pERK1/2 and pElk-1, the enhanced vascular receptor expression, and attenuated the cerebral infarct and improved neurology score. Conclusion Our results show that MCAO results in upregulation of cerebrovascular ETB, AT1 and 5-HT1B receptors. Blockade of this event with a MEK1 inhibitor as late as 6 h after the insult reduced the enhanced vascular receptor expression and the associated cerebral infarction.

FERTILIDAD Y EMBARAZO EN PACIENTES CON ENFERMEDADES INFLAMATORIAS INTESTINALES

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ANDRÉS YARUR U., DR.

2015-09-01

Full Text Available Las Enfermedades Inflamatorias Intestinales (EII son entidades crónicas del tracto digestivo, que afectan frecuentemente a pacientes en edad reproductiva. Debido a las características de estas enfermedades y su tratamiento, existen múltiples desafíos. En este artículo, revisamos la evidencia más reciente con respecto a fertilidad y embarazo en pacientes con EII. En general, existe evidencia de que pacientes con EII tienen una mayor tasa de complicaciones durante el embarazo con respecto a pacientes sin EII. Sin embargo, esta diferencia está directamente asociada al grado de actividad de la enfermedad. La mayor parte de los fármacos hoy usados en el tratamiento de EII son considerados seguros durante el embarazo y se recomienda continuarlos, sobre todo considerando que el mayor riesgo de complicaciones está asociado a una enfermedad activa. Sin embargo es importante considerar las opciones caso a caso. Las dos grandes excepciones son metotrexato y talidomida que están completamente contraindicadas. La recomendación más importante es educar a toda paciente con EII en edad reproductiva, explicando que el embarazo debe llevarse a cabo cuando la enfermedad esté controlada y que la probabilidad de complicaciones está relacionada con el grado de actividad y severidad de la EII. Los médicos tratantes deben educar a las pacientes, enfatizando el seguimiento de los controles y tratamiento.

Enfermedad de Tay-Sachs

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Albia Josefina Pozo Alonso

Full Text Available La enfermedad de Tay-Sachs es un trastorno neurodegenerativo progresivo de herencia autosómica recesiva. Se debe a la deficiencia de la enzima β-hexosaminidasa A, que provoca una acumulación de gangliósidos GM2 en los lisosomas. Se incluye dentro de las esfingolipidosis. De las esfingolipidosis que presentan mancha rojo cereza en la mácula, la enfermedad de Tay-Sachs es la única en la que no se evidencia hepatoesplenomegalia. La variante más frecuente se inicia en la lactancia. Se presenta un lactante del sexo masculino al que se le realizó el diagnóstico de esta entidad a los 8 meses de edad. A partir de los 4 meses comenzó a presentar una reacción de sobresalto. A los 6 meses comenzó a perder habilidades previamente adquiridas y crisis epilépticas mioclónicas. Se constató una disminución de la actividad específica de la enzima hexosaminidasa A en leucocitos.

Las enfermedades de Ludwing Van Beethoven

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Osvaldo Llanos López

2007-08-01

Full Text Available La extraordinaria genialidad y productividad musical de Beethoven no fue disminuida por la influencia de sus múltiples dolencias, sino que por el contrario, en períodos críticos, esta se vio incluso exacerbada. A la sordera, su enfermedad más conocida, pero de causa todavía no precisada, se agregaron otras enfermedades, algunas demostradas en la autopsia, como la cirrosis hepática, la nefropatía, la pancreatitis crónica y otros síndromes sin etiología demostrada, como sus alteraciones gastrointestinales, bronquiales, articulares y oculares. Estas enfermedades, que mortificaron seriamente su vida, pero que no frenaron su creatividad, no pudieron ser controladas por los mejores médicos de la época, con los limitados tratamientos disponibles. Los estudios y especulaciones acerca de su historia médica son abundantes en la literatura y no logran establecer tampoco una patología sistémica que explique al menos la mayoría de sus síndromes. El conocimiento más preciso apunta a que su sordera era de causa mixta, que su cirrosis hepática fue provocada por exceso de alcohol y que la causa de su muerte fue una insuficiencia hepática.

Cerebral angiography with prospective ECG triggering preliminary study of dual-source CT

International Nuclear Information System (INIS)

Xue Yuejun; Qian Nong; Shao Yanhui; Pan Changjie; Rong Weiliang; Xu Yiqun

2012-01-01

Objective: To study the image quality and radiation dose in dual-source CT cerebral angiography with prospective ECG-triggered sequence mode (step-and-shoot, SAS). Methods: A total of forty-three patients with clinically suspected cerebral vascular disease underwent cerebral CT angiography with prospective ECG-triggering (step-and-shoot, SAS). Data acquisition was at 60% R-R interval of the ECG presentation mode. The post-processing included maximum intensity projection (MIP), multiplanar reformation (MPR) and volume rendering (VR). The CTA image quality, radiation dose and rates of excellent images were evaluated. Results: The CTA image quality score was 4.72 ± 0.50 and 97.7% (42/43) patients had excellent CTA images. The average effective dose of SAS-CTA was (0.22 ± 0.01)mSv, which was lower by 76.31% than that of DE-CTA. Conclusions: Prospective ECG-triggering sequence could be used in cerebral angiography with a significant reduction in radiation dose and diagnostic image quality. (authors)

Dietary and plant polyphenols exert neuroprotective effects and improve cognitive function in cerebral ischemia

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Cerebral ischemia is caused by an interruption of blood flow to the brain which generally leads to irreversible brain damage. Ischemic injury is associated with vascular leakage, inflammation, tissue injury, and cell death. Cellular changes associated with ischemia include impairment of metabolism, ...

An investigation of cerebral magnetic resonance angiography, 5

International Nuclear Information System (INIS)

Takeda, Sadanori; Sadamoto, Kazuhiko; Ohue, Shiro; Todo, Hirooki; Sakaki, Saburo.

1992-01-01

A number of studies of MR angiography (MRA) as a noninvasive screening method for vascular diseases have been reported recently. Almost all of them were investigated using high tesla magnets (1.5 tesla). We have been investigating three-dimensional MRA using a medium tesla (0.5 tesla) system (HITACHI G-50). The purpose of this study is to evaluate the usefulness of 3-D MRA for the screening of cerebral aneurysms. Twenty patients with 25 cerebral aneurysms were included in this study. The sizes of the aneurysms ranged from 2 to 35 mm. Twenty-three aneurysms were located on the anterior circulation, and 2 on the posterior circulation. MR angiography was performed with a gradient-echo sequence at a TR of 50 msec, a TE of 16 msec, and a flip angle of 25 degrees. The imaging volumes ranged in thickness from 48 to 64 mm, with 32 partitions. We used a sequence-subtraction technique composed of rephased and dephased sequences; it provides a good visualization of the main cerebral arteries. Cerebral aneurysms were detected on 3-D MRA in 23 lesions (92%). We consider that 0.5 tesla 3-D MRA could be useful for the screening of nonruptured aneurysms. (author)

Pathophysiology of the vascular wall and its relevance for cerebrovascular disorders in aged rodents.

Science.gov (United States)

Popa-Wagner, A; Pirici, D; Petcu, E B; Mogoanta, L; Buga, A-M; Rosen, C L; Leon, R; Huber, J

2010-08-01

Chronic hypertension and cerebral amyloid angiopathy (CAA) are the main pathologies which can induce the rupture of cerebral vessels and intracerebral hemorrhages, as a result of degenerative changes in the vascular wall. A lot of progress has been made in this direction since the successful creation of the first mouse model for the study of Alzheimer's disease (AD), as the spectrum of AD pathology includes a plethora of changes found in pure cerebrovascular diseases. We describe here some of these mouse models having important vascular changes that parallel human AD pathology, and more importantly, we show how these models have helped us understand more about the mechanisms that lead to CAA formation. An important cellular event associated with reduced structural and functional recovery after stroke in aged animals is the early formation of a scar in the infarcted region that impairs subsequent neural recovery and repair. We review recent evidence showing that the rapid formation of the glial scar following stroke in aged rats is associated with premature cellular proliferation that originates primarily from the walls of capillaries in the corpus callosum adjacent to the infarcted region. After stroke several vascular mechanisms are turned-on immediately to protect the brain from further damage and help subsequent neuroregeneration and functional recovery. Although does occur after stroke, vasculogenesis is overshadowed in its protective/restorative role by the angiogenesis and arteriogenesis. Understanding the basic mechanisms underlying functional recovery after cerebral stroke in aging subjects is likely to yield new insights into the treatment of brain injury in the clinic.

Anastomose arterial extra-intracraniana para tratamento de paciente com isquemia cerebral refratária ao manejo clínico

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Falavigna Asdrubal

2004-01-01

Full Text Available A anastomose extra-intracraniana pode ser utilizada em casos selecionados de insuficiência vascular encefálica refratária ao tratamento clínico. Descrevemos um caso de isquemia encefálica em território de artéria cerebral média direita devida à oclusão da artéria carótida interna homolateral com conseqüente redução da perfusão e reserva vascular nos hemisférios frontal e parietal. Apesar do tratamento clínico, a melhora do déficit motor estava relacionada diretamente com a manutenção de níveis tensionais sistêmicos elevados pelo uso de vasopressor. Após anastomose extra-intracraniana término-lateral entre as artérias temporal superficial e cerebral média direita, houve melhora significativa da perfusão cerebral com remissão do déficit motor.

FLAIR vascular hyperintensities and 4D MR angiograms for the estimation of collateral blood flow in anterior cerebral artery ischemia.

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Matthias Gawlitza

Full Text Available To assess FLAIR vascular hyperintensities (FVH and dynamic (4D angiograms derived from perfusion raw data as proposed magnetic resonance (MR imaging markers of leptomeningeal collateral circulation in patients with ischemia in the territory of the anterior cerebral artery (ACA.Forty patients from two tertiary care university hospitals were included. Infarct volumes and perfusion deficits were manually measured on DWI images and TTP maps, respectively. FVH and collateral flow on 4D MR angiograms were assessed and graded as previously specified.Forty-one hemispheres were affected. Mean DWI lesion volume was 8.2 (± 13.9; range 0-76.9 ml, mean TTP lesion volume was 24.5 (± 17.2, range 0-76.7 ml. FVH were observed in 26/41 (63.4% hemispheres. Significant correlations were detected between FVH and TTP lesion volume (ρ = 0.4; P<0.01 absolute (ρ = 0.37; P<0.05 and relative mismatch volume (ρ = 0.35; P<0.05. The modified ASITN/SIR score correlated inversely with DWI lesion volume (ρ = -0.58; P<0.01 and positively with relative mismatch (ρ = 0.29; P< 0.05. ANOVA of the ASITN/SIR score revealed significant inter-group differences for DWI (P<0.001 and TTP lesion volumes (P<0.05. No correlation was observed between FVH scores and modified ASITH/SIR scores (ρ = -0.16; P = 0.32.FVH and flow patterns on 4D MR angiograms are markers of perfusion deficits and tissue at risk. As both methods did not show a correlation between each other, they seem to provide complimentary instead of redundant information. Previously shown evidence for the meaning of these specific MR signs in internal carotid and middle cerebral artery stroke seems to be transferrable to ischemic stroke in the ACA territory.

Affinity proteomics reveals elevated muscle proteins in plasma of children with cerebral malaria.

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Julie Bachmann

2014-04-01

Full Text Available Systemic inflammation and sequestration of parasitized erythrocytes are central processes in the pathophysiology of severe Plasmodium falciparum childhood malaria. However, it is still not understood why some children are more at risks to develop malaria complications than others. To identify human proteins in plasma related to childhood malaria syndromes, multiplex antibody suspension bead arrays were employed. Out of the 1,015 proteins analyzed in plasma from more than 700 children, 41 differed between malaria infected children and community controls, whereas 13 discriminated uncomplicated malaria from severe malaria syndromes. Markers of oxidative stress were found related to severe malaria anemia while markers of endothelial activation, platelet adhesion and muscular damage were identified in relation to children with cerebral malaria. These findings suggest the presence of generalized vascular inflammation, vascular wall modulations, activation of endothelium and unbalanced glucose metabolism in severe malaria. The increased levels of specific muscle proteins in plasma implicate potential muscle damage and microvasculature lesions during the course of cerebral malaria.

[Etiologies of cerebral palsy and classical treatment possibilities].

Science.gov (United States)

Maurer, Ute

2002-01-01

Cerebral palsy is a non-progressive disorder of the developing brain with different etiologies in the pre-, peri- or postnatal period. The most important of these diseases is cystic periventricular leukomalacia (PVL), followed by intra- and periventricular hemorrhage, hypoxic-ischemic encephalopathy, vascular disorders, infections or brain malformations. The underlying cause is always a damage of the first motor neuron. Prevalence of cerebral palsy in Europe is 2-3 per 1000 live births with a broad spectrum in different birth weight groups. Our own data concerning only pre-term infants in the NICU with birth weight below 1500 g (VLBW) are between 10%-20%. Established classical treatment methods include physiotherapy (Bobath, Vojta, Hippotherapy), methods of speech and occupational therapists (Castillo-Morales, Sensory Integration) and other therapeutical concepts (Petö, Affolter, Frostig).

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

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Dóris Firmino Rabelo

2006-08-01

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

Assessment by three-dimensional power Doppler ultrasound of cerebral blood flow perfusion in fetuses with congenital heart disease.

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Zeng, S; Zhou, J; Peng, Q; Tian, L; Xu, G; Zhao, Y; Wang, T; Zhou, Q

2015-06-01

To use three-dimensional (3D) power Doppler ultrasound to investigate cerebral blood flow perfusion in fetuses with congenital heart disease (CHD). The vascularization index (VI), flow index (FI) and vascularization flow index (VFI) in the total intracranial volume and the main arterial territories (middle cerebral artery (MCA), anterior cerebral artery (ACA) and posterior cerebral artery (PCA)) were evaluated prospectively and compared in 112 fetuses with CHD and 112 normal fetuses using 3D power Doppler. Correlations between the 3D power Doppler indices and neurodevelopment scores at 12 months of age were assessed in a subset of the CHD group, and values were compared with those of controls. Compared with the controls, the VI, FI and VFI of the total intracranial volume and the three main arteries were significantly higher in fetuses with hypoplastic left heart syndrome and left-sided obstructive lesions (P power Doppler values in the ACA territory were significantly higher in fetuses with transposition of the great arteries (P power Doppler ultrasound might help to identify cases of brain vasodilatation earlier and inform parental counseling. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

Dyke-Davidoff-Masson syndrome: case report of fetal unilateral ventriculomegaly and hypoplastic left middle cerebral artery.

Science.gov (United States)

Piro, Ettore; Piccione, Maria; Marrone, Gianluca; Giuffrè, Mario; Corsello, Giovanni

2013-05-14

Prenatal ultrasonographic detection of unilateral cerebral ventriculomegaly arises suspicion of pathological condition related to cerebrospinal fluid flow obstruction or cerebral parenchimal pathology. Dyke-Davidoff-Masson syndrome is a rare condition characterized by cerebral hemiatrophy, calvarial thickening, skull and facial asymmetry, contralateral hemiparesis, cognitive impairment and seizures. Congenital and acquired types are recognized and have been described, mainly in late childhood, adolescence and adult ages. We describe a female infant with prenatal diagnosis of unilateral left ventriculomegaly in which early brain MRI and contrast enhanced-MRI angiography, showed cerebral left hemiatrophy associated with reduced caliber of the left middle cerebral artery revealing the characteristic findings of the Dyke-Davidoff-Masson syndrome. Prenatal imaging, cerebral vascular anomaly responsible for the cerebral hemiatrophy and the early clinical evolution have never been described before in such a young child and complete the acquired clinical descriptions in older children. Differential diagnosis, genetic investigations, neurophysiologic assessments, short term clinical and developmental follow up are described. Dyke-Davidoff-Masson syndrome must be ruled out in differential diagnosis of fetal unilateral ventriculomegaly. Early clinical assessment, differential diagnosis and cerebral imaging including cerebral MRI angiography allow the clinicians to diagnose also in early infancy this rare condition.

Posttherapeutic cerebral radionecrosis: a complication of head and neck tumor therapy

International Nuclear Information System (INIS)

Araoz, C.; Weems, A.M.

1981-01-01

Patients with treated head and neck cancer may have focal neurologic symptoms and personality changes due to delayed cerebral radionecrosis. A history of past treatment should direct the physician to consider these lesions in the differential diagnosis. Craniotomy is the management recommended. Histopathologic changes include fibrotic response of the meninges with pleomorphic and vacuolated fibroblasts, capillary hyperplasia, reactive astrocytes, and fibrosis of the blood vessels. Amyloid is deposited in the arteriolar walls and extracellular space. Ischemic, autoimmune, or vascular mechanisms, and glial alterations have all been considered in the pathogensis of delayed cerebral radionecrosis. Some researchers have concluded that chemotherapeutic agents, such as methotrexate, may contribute to its production

Electroacupuncture preconditioning reduces cerebral ischemic injury via BDNF and SDF-1α in mice

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Kim Ji Hyun

2013-01-01

Full Text Available Abstract Background This study was designed to determine if electroacupuncture (EA preconditioning improves tissue outcome and functional outcome following experimentally induced cerebral ischemia in mice. In addition, we investigated whether the expression of brain-derived neurotrophic factor (BDNF and stromal cell derived factor-1α (SDF-1α and infarct volume were related with improvement in neurological and motor function by interventions in this study. Methods After treatment with EA at the acupoints ‘Baihui (GV20’ and ‘Dazhui (GV14’ for 20 min, BDNF was assessed in the cortical tissues based on Western blot and the SDF-1α and vascular endothelial growth factor (VEGF levels in the plasma determined by ELISA. To assess the protective effects of EA against ischemic injury, the mice received once a day 20 min EA preconditioning for three days prior to the ischemic event. Focal cerebral ischemia was then induced by photothrombotic cortical ischemia. Infarct volumes, neurobehavioral deficit and motor deficit were evaluated 24 h after focal cerebral ischemia. Results The expression of BDNF protein increased significantly from 6 h, reaching a plateau at 12 h after the end of EA treatment in the cerebral cortex. Furthermore, SDF-1α, not VEGF, increased singnificantly from 12 h to 48 h after EA stimulation in the plasma. Moreover, EA preconditioning reduced the infarct volume by 43.5% when compared to control mice at 24 h after photothrombotic cortical ischemia. Consistent with a smaller infarct size, EA preconditioning showed prominent improvement of neurological function and motor function such as vestibule-motor function, sensori-motor function and asymmetric forelimb use. The expression of BDNF colocalized within neurons and SDF-1α colocalized within the cerebral vascular endothelium was observed throughout the ischemic cortex by EA. Conclusions Pretreatment with EA increased the production of BDNF and SDF-1α, which elicited

Una lengua común: poéticas y políticas de la enfermedad

OpenAIRE

Martínez García, Miguel Ángel

2015-01-01

La tesis "Una lengua común: poéticas y políticas de la enfermedad" analiza un corpus de textos literarios recientes (publicados en su mayoría después del año 2000) en los que se tematiza el motivo de la enfermedad. La tesis interroga la dimensión social y política de las formas actuales de la enfermedad a partir de sus representaciones literarias. El punto de partida de la tesis consiste en la constatación de que algunas enfermedades (como el cáncer o las llamadas "enfermedades del vacío" o "...

Enfermedades y Geopolítica en Colombia

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Hugo Armando Sotomayor Tribin

1997-01-01

El presente artículo “Enfermedades y geopolítica en Colombia” relacionará las enfermedades con dos fenómenos sociales y políticos que han pesado grandemente en la conformación histórica de nuestro país: el acento político y el progreso económico para algunas regiones, al tiempo que el descuido y abandono para otra, y el racismo.

El primero, el relacionado con la asignación de una mayor importancia en un momento dado a algunas regiones y su contrapartida, el descuido...

Úvea y enfermedades sistémicas

OpenAIRE

Pablo Sabat, O.; Víctor Velásquez, R.

2010-01-01

El ojo, además de entregarnos el sentido de la visión, también nos permite conocer la salud general del organismo. Muchas enfermedades sistémicas se manifiestan en el órgano visual antes, durante o después del debut de ellas a nivel sistémico. Este compromiso visual es variado y depende de la enfermedad en cuestión, destacando la escleritis, uveítis y vasculitis retinales. Conocer el estado ocular permitirá al clínico realizar diagnósticos más asertivos y oportunos, realizar el tratamiento má...

El dolor en la enfermedad de Parkinson. Implicaciones autonómicas y afectivas

OpenAIRE

Camacho Conde, José

2016-01-01

Introducción y objetivo: La enfermedad de Parkinson (EP) es una enfermedad neurodegenerativa, la segunda con mayor prevalencia, después de la enfermedad de Alzheimer (EA). La enfermedad presenta tanto síntomas motores como “no motores”, entre los que se encuentra disfunción autonómica, dolor, deterioro cognitivo, ansiedad, depresión, entre otros. El dolor en la EP, a pesar de su frecuencia, sigue siendo un síntoma infravalorado, infradiagnosticado e infratratado. Nuestro objetivo principal es...

Intra-arterial angio-CT for radiosurgery of cerebral arteriovenous malformations

International Nuclear Information System (INIS)

Tanami, Yutaka; Kunieda, Etsuo; Onozuka, Satoshi

1998-01-01

Intra-arterial CT-angiograms were performed for four patients undergoing stereotactic radiosurgery for cerebral arteriovenous malformations (AVM). Helical and dynamic CT scans were carried out with a scanner installed in a angiographic examination room following routine angiography. Helical scans were performed with continuous arterial infusion of contrast media. Then, dynamic scans were repeated at several table positions. Subtractions were achieved for a post-embolization case. Normal and pathological vascular structures were demonstrated with different enhancement phases with the dynamic scans. The coordinates of the target points in the nidus could be clearly determined. We concluded that intra-arterial CT-angiograms are practical and useful for treatment planning of radiosurgery for cerebral AVM. (author)

Intra-arterial angio-CT for radiosurgery of cerebral arteriovenous malformations

Energy Technology Data Exchange (ETDEWEB)

Tanami, Yutaka; Kunieda, Etsuo; Onozuka, Satoshi [Keio Univ., Tokyo (Japan) School of Medicine] [and others

1998-08-01

Intra-arterial CT-angiograms were performed for four patients undergoing stereotactic radiosurgery for cerebral arteriovenous malformations (AVM). Helical and dynamic CT scans were carried out with a scanner installed in a angiographic examination room following routine angiography. Helical scans were performed with continuous arterial infusion of contrast media. Then, dynamic scans were repeated at several table positions. Subtractions were achieved for a post-embolization case. Normal and pathological vascular structures were demonstrated with different enhancement phases with the dynamic scans. The coordinates of the target points in the nidus could be clearly determined. We concluded that intra-arterial CT-angiograms are practical and useful for treatment planning of radiosurgery for cerebral AVM. (author)

Regional cerebral blood flow of Moyamoya disease in the chronic state as studied using a three-dimensional method. With special reference to CO/sub 2/ response and autoregulation

Energy Technology Data Exchange (ETDEWEB)

Ejiri, Takao; Endo, Hideo; Kubo, Naohiko; Kanaya, Haruyuki

1986-02-01

Regional cerebral blood flow (rCBF) was measured in six adult and five juvenile cases with moyamoya disease, using single-photon-emission CT and the Xe-133 inhalation method. In the resting state, the rCBF value in the basal moyamoya region was within normal limits. The characteristic of rCBF was a decrease in the cerebral cortex, especially in the temporal region of the juvenile cases. CO/sub 2/ response by 5 % CO/sub 2/ inhalation was disturbed not only in the cerebral cortex, but also in the basal moyamoya region; also the degree of such impairment showed site-to-site differences. On the other hand, rCBF changes under hyperventilation showed a good response in the cerebral cortex, but was mostly absent in the basal moyamoya region. Autoregulation under induced hypertension seemed to be preserved both in the cerebral cortex and in the basal moyamoya region. Under induced hypotension, however, an impairment of autoregulation was shown both in the cerebral cortex and in the basal moyamoya region. The rCBF value in the cerebellum was slightly higher than that in the cerebrum. The vascular response of the cerebellum was not preserved under hypercapnia and hypotension; however, it showed almost normal behavior under hypocapnia and hypertension. In summary, it might be concluded that the impairment of vascular response in the basal moyamoya region during various functional tests was not due to the secondary effects following the decrease in the rCBF. It may also be speculated that these impairments of vascular response may be directly attributed to various pathological alterations in the arterial vascular wall, i.e., the maximal dilatation and rigidity of the vessels in the moyamoya region, as evidenced in the previous reports.

Incidência de acidente cerebro-vascular embólico na cardiopatia chagásica crônica

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A. Spina-França

1974-09-01

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

Enfermedad de Hashimoto

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Hernando Latorre

1956-01-01

Full Text Available Se describe un caso de enfermedad de hashimoto en una enferma de 47 años y se hacen algunos comentarios sobre la interpretación y relaciones de esta entidad con el coto de riedel y el coto linfadenoide. La lesión al examen clínico simuló un tumor maligno de tiroides, diagnóstico con el cual fue remitido el órgano al laboratorio de anatomía patológica.

Enfermedad de Gaucher en Latinoamérica: Un informe del Registro Internacional y del Grupo Latinoamericano para la Enfermedad de Gaucher

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Guillermo Drelichman

2012-08-01

Full Text Available La enfermedad de Gaucher, por su escasa frecuencia, está incluida dentro de las llamadas enfermedades huérfanas. En 1991 se creó el Registro Internacional de Gaucher y en 1992 se incorporaron los primeros pacientes de Latinoamérica. En el año 2008 se creó el Grupo Latinoamericano para la Enfermedad de Gaucher (GLAEG cuyos principales objetivos son fomentar la realización de consensos regionales, difundir el ingreso de pacientes al registro internacional y aumentar el conocimiento sobre la enfermedad para lograr mejorar la atención y la calidad de vida de los pacientes. Hasta abril del 2010 ingresaron 5828 pacientes de todo el mundo, 911 (15.6% son de Latinoamérica. Este es el primer informe global de la enfermedad en la Región: hay un predominio del sexo femenino, la forma clínica más frecuente es el tipo I (95%; al diagnóstico la mayoría son <20 años (68%. Las manifestaciones clínicas más frecuentes al diagnóstico son esplenomegalia (96% y anemia (49%, el 80% presentó hallazgos radiológicos de compromiso óseo. En nuestra Región, la gran mayoría de los pacientes (89% ha recibido alguna vez terapia de reemplazo enzimática con imiglucerasa logrando, con un seguimiento prolongado (hasta10 años, las metas terapéuticas que muestran la gran eficacia de la terapia. Si bien el porcentaje de pacientes con terapia es alto, las suspensiones de tratamiento son frecuentes. Las principales deficiencias en nuestra Región son: la carencia de evaluaciones viscerales volumétricas, de densitometría y de estudios moleculares en algunos pacientes. El principal problema es el subdiagnóstico.

Effect of acute exposure to hypergravity (GX vs. GZ) on dynamic cerebral autoregulation

Science.gov (United States)

Serrador, J. M.; Wood, S. J.; Picot, P. A.; Stein, F.; Kassam, M. S.; Bondar, R. L.; Rupert, A. H.; Schlegel, T. T.

2001-01-01

We examined the effects of 30 min of exposure to either +3GX (front-to-back) or +GZ (head-to-foot) centrifugation on cerebrovascular responses to 80 degrees head-up tilt (HUT) in 14 healthy individuals. Both before and after +3 GX or +3 GZ centrifugation, eye-level blood pressure (BP(eye)), end tidal PCO2 (PET(CO2)), mean cerebral flow velocity (CFV) in the middle cerebral artery (transcranial Doppler ultrasound), cerebral vascular resistance (CVR), and dynamic cerebral autoregulatory gain (GAIN) were measured with subjects in the supine position and during subsequent 80 degrees HUT for 30 min. Mean BP(eye) decreased with HUT in both the GX (n = 7) and GZ (n = 7) groups (P centrifugation only in the GZ group (P centrifugation. CFV decreased during HUT more significantly after centrifugation than before centrifugation in both groups (P centrifugation compared with before centrifugation, GAIN increased in both groups (P centrifugation resulted in a leftward shift of the cerebral autoregulation curve. We speculate that this leftward shift may have been due to vestibular activation (especially during +GX) or potentially to an adaptation to reduced cerebral perfusion pressure during +GZ.

CD8+ T Cells Induce Fatal Brainstem Pathology during Cerebral Malaria via Luminal Antigen-Specific Engagement of Brain Vasculature.

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Phillip A Swanson

2016-12-01

Full Text Available Cerebral malaria (CM is a severe complication of Plasmodium falciparum infection that results in thousands of deaths each year, mostly in African children. The in vivo mechanisms underlying this fatal condition are not entirely understood. Using the animal model of experimental cerebral malaria (ECM, we sought mechanistic insights into the pathogenesis of CM. Fatal disease was associated with alterations in tight junction proteins, vascular breakdown in the meninges / parenchyma, edema, and ultimately neuronal cell death in the brainstem, which is consistent with cerebral herniation as a cause of death. At the peak of ECM, we revealed using intravital two-photon microscopy that myelomonocytic cells and parasite-specific CD8+ T cells associated primarily with the luminal surface of CNS blood vessels. Myelomonocytic cells participated in the removal of parasitized red blood cells (pRBCs from cerebral blood vessels, but were not required for the disease. Interestingly, the majority of disease-inducing parasite-specific CD8+ T cells interacted with the lumen of brain vascular endothelial cells (ECs, where they were observed surveying, dividing, and arresting in a cognate peptide-MHC I dependent manner. These activities were critically dependent on IFN-γ, which was responsible for activating cerebrovascular ECs to upregulate adhesion and antigen-presenting molecules. Importantly, parasite-specific CD8+ T cell interactions with cerebral vessels were impaired in chimeric mice rendered unable to present EC antigens on MHC I, and these mice were in turn resistant to fatal brainstem pathology. Moreover, anti-adhesion molecule (LFA-1 / VLA-4 therapy prevented fatal disease by rapidly displacing luminal CD8+ T cells from cerebrovascular ECs without affecting extravascular T cells. These in vivo data demonstrate that parasite-specific CD8+ T cell-induced fatal vascular breakdown and subsequent neuronal death during ECM is associated with luminal, antigen

Vascular pathology: Cause or effect in Alzheimer disease?

Science.gov (United States)

Rius-Pérez, S; Tormos, A M; Pérez, S; Taléns-Visconti, R

2018-03-01

Alzheimer disease (AD) is the main cortical neurodegenerative disease. The incidence of this disease increases with age, causing significant medical, social and economic problems, especially in countries with ageing populations. This review aims to highlight existing evidence of how vascular dysfunction may contribute to cognitive impairment in AD, as well as the therapeutic possibilities that might arise from this evidence. The vascular hypothesis emerged as an alternative to the amyloid cascade hypothesis as an explanation for the pathophysiology of AD. This hypothesis locates blood vessels as the origin for a variety of pathogenic pathways that lead to neuronal damage and dementia. Destruction of the organisation of the blood brain barrier, decreased cerebral blood flow, and the establishment of an inflammatory context would thus be responsible for any subsequent neuronal damage since these factors promote aggregation of β-amyloid peptide in the brain. The link between neurodegeneration and vascular dysfunction pathways has provided new drug targets and therapeutic approaches that will add to the treatments for AD. It is difficult to determine whether the vascular component in AD is the cause or the effect of the disease, but there is no doubt that vascular pathology has an important relationship with AD. Vascular dysfunction is likely to act synergistically with neurodegenerative changes in a cycle that exacerbates the cognitive impairment found in AD. Copyright © 2015 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Arterial vascularization patterns of the splenium: An anatomical study.

Science.gov (United States)

Kahilogullari, G; Comert, A; Ozdemir, M; Brohi, R A; Ozgural, O; Esmer, A F; Egemen, N; Karahan, S T

2013-09-01

The aim of this study was to provide detailed information about the arterial vascularization of the splenium of the corpus callosum (CC). The splenium is unique in that it is part of the largest commissural tract in the brain and a region in which pathologies are seen frequently. An exact description of the arterial vascularization of this part of the CC remains under debate. Thirty adult human brains (60 hemispheres) were obtained from routine autopsies. Cerebral arteries were separately cannulated and injected with colored latex. Then, the brains were fixed in formaldehyde, and dissections were performed using a surgical microscope. The diameter of the arterial branches supplying the splenium of the CC at their origin was investigated, and the vascularization patterns of these branches were observed. Vascular supply to the splenium was provided by the anterior pericallosal artery (40%) from the anterior circulation and by the posterior pericallosal artery (88%) and posterior accessory pericallosal artery (50%) from the posterior circulation. The vascularization pattern of the splenium differs in each hemisphere and is usually supplied by multiple branches. The arterial vascularization of the splenium of the CC was studied comprehensively considering the ongoing debate and the inadequacy of the studies on this issue currently available in the literature. This anatomical knowledge is essential during the treatment of pathologies in this region and especially for splenial arteriovenous malformations.

Reporte de familias con neurofibromatosis y otras enfermedades genéticas

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Orraca Castillo, Miladys; Licourt Otero, Deysi; Sánchez Álvarez de La Campa, Ana Isabel

2011-01-01

La neurofibromatosis tipo 1, es una enfermedad genética que primariamente afecta el desarrollo y crecimiento celular del sistema nervioso, clínicamente se caracteriza por máculas café con leche, neurofibromas, pecas en regiones no expuestas al sol, nódulos de Lisch, lesiones óseas y glioma óptico. En el presente trabajo se describen dos familias, en las cuales algunos individuos padecen esta enfermedad y otros miembros de la misma familia muestran una diferente enfermedad genética. La coexist...

Obesidad y enfermedad renal: consecuencias ocultas de la epidemia

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Csaba P. Kovesdy

2017-07-01

Full Text Available La obesidad se ha convertido en una epidemia mundial, y se ha proyectado que su prevalencia se incrementrá en un 40% en la próxima década. Esta creciente prevalencia supone implicaciones tanto para el riesgo de desarrollo de diabetes y enfermedades cardiovasculares como para el desarrollo de enfermedad renal crónica. Un elevado índice de masa corporal es uno de los factores de riesgo más importantes para el desarrollo de enfermedad renal crónica. En individuos afectados por la obesidad, tiene lugar una hiperfiltración compensatoria necesaria para alcanzar la alta demanda metabólica secundaria al aumento del peso corporal. El incremeno de la presión intraglomerular puede generar daño renal y elevar el riesgo de desarrollar enfermedad renal crónica a largo plazo. La incidencia de glomerulopatía asociada a obesidad se ha incrementado 10 veces en los últimos años. Así mismo se ha demostrado que la obesidad es un factor de riesgo para el desarrollo de nefrolitiasis y un número de neoplasias, incluyendo cáncer renal. Este año, el Día Mundial del Riñón promueve la educación acerca de las consecuencias nocivas de la obesidad y su asociación con la enfermedad renal, abogando por un estilo de vida saludable y la implementación de políticas publicas de salud que promuevan medidas preventivas alcanzables.

Cerebrovascular endothelin receptor upregulation in cerebral ischemia

DEFF Research Database (Denmark)

Edvinsson, Lars

2009-01-01

Stroke is a serious neurological disease and the third leading cause of death in the western world. In roughly 15 % of the cases, the cause is due to an intracranial haemorrhage, and the remaining 85 % represent ischemic strokes. Ischemic stroke is caused by the occlusion of a cerebral artery...... either by an embolus or by local thrombosis. Several studies have shown an involvement of the endothelin system in ischemic stroke. This review aims to examine the alterations of vascular endothelin receptor expression in ischemic stroke. Furthermore, studies of the intracellular signalling pathways...... leading to the enhanced expression of vascular endothelin receptors show that both protein kinase C (PKC) and mitogen activating protein kinase (MAPK) play important roles. The results from this work provide new perspectives on the pathophysiology of ischemic stroke, and give a possible explanation...

Uso de derivados de quinazollnas y sus composiciones farmacéuticas en enfermedades neurodegenerativas

OpenAIRE

Martínez, Ana; Redondo, Miriam; Sanz-SanCristóbal, Marina; Gil, Carmen; Morales-García, José A.; Pérez Castillo, Ana; Pérez Martín, María Concepción

2009-01-01

Uso de derivados de quinazolinas y sus composiciones farmacéuticas en enfermedades neurodegenerativas. La invención se refiere a derivados heterocíclicos de quinazolinas y a su potencial para el tratamiento de enfermedades neurodegenerativas y/o neurológicas, entre otras la enfermedad de Parkinson, enfermedad de Alzheimer o esclerosis. Además, la invención se refiere a composiciones farmacéuticas que comprenden dichos compuestos derivados de quinazolinas.

Egas Moniz: 90 Years (1927–2017) from Cerebral Angiography

Science.gov (United States)

Artico, Marco; Spoletini, Marialuisa; Fumagalli, Lorenzo; Biagioni, Francesca; Ryskalin, Larisa; Fornai, Francesco; Salvati, Maurizio; Frati, Alessandro; Pastore, Francesco Saverio; Taurone, Samanta

2017-01-01

In June 2017 we celebrate the 90th anniversary of the pioneer discovery of cerebral angiography, the seminal imaging technique used for visualizing cerebral blood vessels and vascular alterations as well as other intracranial disorders. Egas Moniz (1874–1955) was the first to describe the use of this revolutionary technique which, until 1975 (when computed tomography, CT, scan was introduced in the clinical practice), was the sole diagnostic tool to provide an imaging of cerebral vessels and therefore alterations due to intracranial pathology. Moniz introduced in the clinical practice this fundamental and important diagnostic tool. The present contribution wishes to pay a tribute to the Portuguese neurosurgeon, who was also a distinguished neurologist and statesman. Despite his tremendous contribution in modern brain imaging, Egas Moniz was awarded the Nobel Prize in Physiology or Medicine in 1949 for prefrontal leucotomy, the neurosurgical intervention nowadays unacceptable, but should rather be remembered for his key contribution to modern brain imaging. PMID:28974927

Egas Moniz: 90 Years (1927–2017 from Cerebral Angiography

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Marco Artico

2017-09-01

Full Text Available In June 2017 we celebrate the 90th anniversary of the pioneer discovery of cerebral angiography, the seminal imaging technique used for visualizing cerebral blood vessels and vascular alterations as well as other intracranial disorders. Egas Moniz (1874–1955 was the first to describe the use of this revolutionary technique which, until 1975 (when computed tomography, CT, scan was introduced in the clinical practice, was the sole diagnostic tool to provide an imaging of cerebral vessels and therefore alterations due to intracranial pathology. Moniz introduced in the clinical practice this fundamental and important diagnostic tool. The present contribution wishes to pay a tribute to the Portuguese neurosurgeon, who was also a distinguished neurologist and statesman. Despite his tremendous contribution in modern brain imaging, Egas Moniz was awarded the Nobel Prize in Physiology or Medicine in 1949 for prefrontal leucotomy, the neurosurgical intervention nowadays unacceptable, but should rather be remembered for his key contribution to modern brain imaging.

Manifestaciones neuroftalmológicas en la enfermedad de Parkinson

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Yoel Nicomedes Rodríguez Martín

Full Text Available La enfermedad de Parkinson es un desorden neurodegenerativo progresivo provocado por un déficit de dopamina que desencadena importantes alteraciones motoras y no motoras. Dentro de estas, un considerable grupo constituye motivo de interés para el neuroftalmólogo. La enfermedad ha sido siempre más reconocida por sus alteraciones motoras. El objetivo fundamental de esta revisión es hacer énfasis en el diagnóstico de las afectaciones visuales en la enfermedad de Parkinson y de esta forma mejorar en lo posible la calidad de vida de los pacientes. Se realizó una amplia búsqueda en PUBMED y se revisaron 60 artículos relacionados con el tema, publicados entre los años 1984 y 2012.

Impact of a Vascular Neurosurgery Simulation-Based Course on Cognitive Knowledge and Technical Skills in European Neurosurgical Trainees.

Science.gov (United States)

Zammar, Samer G; El Tecle, Najib E; El Ahmadieh, Tarek Y; Adelson, P David; Veznedaroglu, Erol; Surdell, Daniel L; Harrop, James S; Benes, Vladimir; Rezai, Ali R; Resnick, Daniel K; Bendok, Bernard R

2015-08-01

To assess microsurgical and diagnostic cerebral angiography modules and their corresponding objective assessment scales as educational tools for European neurosurgical residents at the European Association of Neurosurgical Societies Resident Vascular Neurosurgery course, which was held in Prague, Czech Republic, on September 2013. Microsurgical skills and cerebral angiography are fundamental skills in vascular neurosurgery. There is a need to develop a simulation-based curriculum focusing on these skills for neurosurgical trainees worldwide. The course consisted of 2 modules: microanastomosis and diagnostic cerebral angiography. In addition to an initial screening survey, each module was divided into 3 components: 1) a before didactic cognitive knowledge and technical skills testing, 2) a didactic lecture, and 3) an after didactic cognitive knowledge and technical skills testing. We compared the trainees' cognitive and technical scores from the before and after testing phases. Wilcoxon sum rank test was used to test statistical significance. The knowledge test median scores increased from 63% and 68% to 80% and 88% (P technical proficiency. Copyright © 2015. Published by Elsevier Inc.

La enfermedad periodontal asociada al paciente con Síndrome de Down

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Rubens Demicheri A.

Full Text Available Resumen: El Síndrome de Down es una de las condiciones de discapacidad más comunes. Dentro de las patologías bucales más prevalentes, la enfermedad periodontal es una de las asociadas con este síndrome. Se considera que la persona con Síndrome de Down presenta una mayor susceptibilidad a contraer esta enfermedad. En este artículo se describen los factores etiológicos y las características clínicas de la enfermedad en pacientes portadores del síndrome

Effects of heavy-ion radiation on the brain vascular system

International Nuclear Information System (INIS)

Yang, T.C.; Craise, L.M.; Tobias, C.A.

1985-01-01

In the laboratory, the authors have been studying the effects of heavy-ion radiation on the vascular system, using neonatal rats as a model system. They investigated the response of the brain vascular system to ionizing radiation and found that distinct petechial hemorrhages developed in the cerebral cortex within a few hours after irradiation, reached a maximum after about 13 to 24 hours, and then decreased exponentially with time. No brain hemorrhage was found in neonatal rats 12 days after irradiation. Heavy ions induce more hemorrhages than x rays for a given dose, and the RBE for 670-MeV/u neon particles ranges from about 2.0 for low doses to about 1.4 for high doses

La enfermedad de manos, pies y boca (Hand, Foot, and Mouth Disease)

Centers for Disease Control (CDC) Podcasts

La enfermedad de manos, pies y boca es una enfermedad contagiosa que afecta principalmente a niños menores de cinco años. En este podcast, la doctora Eileen Schneider habla de los síntomas de la enfermedad de manos, pies y boca, cómo se propaga y cómo protegerse y proteger a sus hijos para que no se infecten con el virus.

Impaired cerebral blood flow and oxygenation during exercise in type 2 diabetic patients

DEFF Research Database (Denmark)

Kim, Yu-Sok; Seifert, Thomas; Brassard, Patrice

2015-01-01

Endothelial vascular function and capacity to increase cardiac output during exercise are impaired in patients with type 2 diabetes (T2DM). We tested the hypothesis that the increase in cerebral blood flow (CBF) during exercise is also blunted and, therefore, that cerebral oxygenation becomes...... affected and perceived exertion increased in T2DM patients. We quantified cerebrovascular besides systemic hemodynamic responses to incremental ergometer cycling exercise in eight male T2DM and seven control subjects. CBF was assessed from the Fick equation and by transcranial Doppler-determined middle...... at higher workloads in T2DM patients and their work capacity and increase in cardiac output were only ~80% of that established in the control subjects. CBF and cerebral oxygenation were reduced during exercise in T2DM patients (P

Treino de vibração de corpo inteiro na função motora em pacientes acometidos por acidente vascular cerebral : Whole body vibration training in motor function in patients affected with stroke

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Adriana Teresa Silva

2015-01-01

Resumo: O Acidente Vascular Cerebral (AVC) é um problema de saúde pública relevante em virtude de sua alta frequência e de grande impacto na população. Os sobreviventes apresentam sequelas que implicam algum grau de dependência e um elevado custo social. Minimizar as sequelas e aumentar a recuperação funcional tem sido um ponto importante para os profissionais da reabilitação. O objetivo do artigo 1 foi verificar os efeitos do treino de vibração de corpo inteiro nos pacientes acometidos por A...

Local vascular CO2 reactivity in the infant brain assessed by functional MRI

DEFF Research Database (Denmark)

Toft, P.B.; Leth, H; Lou, H.C.

1995-01-01

of the brain slice investigated decreased by 1.2-2.6% per kPa change in PCO2 as a reflection of decreased cerebral blood flow during hyperventilation. Pixel-wise analysis revealed absence of vascular response in the basal ganglia, the thalamus or in the occipital region. In two adult controls, who...

Diagnosis and differential diagnosis of cerebro-vascular malformations by CT

International Nuclear Information System (INIS)

Schumacher, M.; Stoeter, P.; Voigt, K.

1980-01-01

In 38 patients, the diagnosis of a cerebrovascular malformation (17 arteriovenous angiomas including one low-flow- and two venous angiomas; 10 aneurysms; 4 arteriovenous fistulae of the cavernous sinus, the tentorium and one of the Great Vein of Galen; 6 megadolical basilar arteries) was initially made by computertomographic (CT) examination, including contrast enhancement. The characteristic and pathognomonic CT findings are described and compared with those of cerebral angiography also done in these cases. The problems of differential diagnosis and the reasons for a false CT diagnosis in 5 other patients with a cerebro-vascular malformation are investigated; and the diagnostic value of cerebral angiography and CT is discussed and their complementary functions are being pointed out. (orig.) 891 MG/orig. 892 MKO [de

Enfermedad periodontal inflamatoria asociada a un absceso pulmonar. Presentación de un caso

OpenAIRE

López Rodríguez, Vania Julexis; Garcías Rodríguez, Marisel; Gómez Martínez, Ana Iris; Díaz Gonzáles, Gabriela

2015-01-01

Fundamento: A pesar, de que hay reportes de casos en la literatura internacional, que asocian la enfermedad periodontal con enfermedades respiratorias y medidas para la prevención de la enfermedad periodontal inflamatoria, sino se establece un adecuado manejo de esta última, puede evolucionar con una complicación sistémica como es el absceso pulmonar. Objetivo: Ilustrar cómo la enfermedad periodontal inflamatoria puede asociarse a un absceso pulmonar como complicación sistémica en su evolució...

El desafío de la gestión de las enfermedades profesionales: solvitas perambulum

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Clara Guillén Subirán

2014-01-01

Full Text Available Los cambios que tienen lugar en el entorno laboral repercuten en la naturaleza de las enfermedades profesionales planteando cada vez más desafíos. Este artículo se centra en ellos: el concepto enfermedad profesional tiene un carácter legal y no médico, las nuevas patologías y las enfermedades emergentes, las enfermedades profesionales con largos periodos de latencia, las posibles causas de las enfermedades profesionales que son incluso más complejas que la definición, porque, en muchos casos, los factores relacionados con el trabajo aumentan el riesgo de sufrir una enfermedad junto con otros factores extralaborales. Es precisamente esta compleja multicasualidad de las enfermedades profesionales la que no solo dificulta su reconocimiento y registro sino también su prevención y aseguramiento. En definitiva, se deberían desarrollar algunos métodos y realizar prácticas adecuadas para proponer estrategias,que respondan a estos retos: aseguramiento de una notificación fiable y motivación para que se notifique, fortalecimiento de la calidad del diagnóstico, seguimiento de los trabajadores expuestos, revisión y actualización de las listas de enfermedades profesionales y promoción de la prevención de las enfermedades profesionales.

LA TERAPIA DE REMPLAZO ENZIMÁTICO ENZIMÁTICO TRATAMIENTO ENFERMEDADES EN EL TRATAMIENTO DE ENFERMEDADES GENÉTICAS

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Homero Sáenz

2003-12-01

Full Text Available La terapia de remplazo enzimático (TRE, consiste en suministrarle a un paciente una proteína exógena, que en su organismo está siendo sintetizada anormalmente. La proteína puede provenir de tejidos y fluidos humanos, ser sintetizada en bacterias, células de mamífero o levaduras, a las cuales se les ha introducido el gen correspondiente. Actualmente son tratadas con TRE las enfermedades de Gaucher, Fabry y la inmunodeficiencia humana combinada. Además existen avanzados estudios en las enfermedades de Hurler, Hunter, Pompe, Niemann-Pick tipo B, Morquio A, angioderma hereditario y pénfigo vulgar. Una de las limitantes de la TRE ha sido sus altos costos, debido al relativamente pequeño número de pacientes que se tratan a nivel mundial y a que el sistema usado hasta ahora, es decir, la expresión en células de mamífero, requiere procedimientos muy costosos. La expresión en bacterias o levaduras sería mucho más barato, pero las primeras no expresan proteínas glicosiladas que constituyen el 91% del total de proteínas y la mayoría de las levaduras tienen sistemas de glicosilación, distintos a los de mamíferos.Sin embargo, Pichia pastoris y Hansenula polymorpha parecen producir proteínas muy similares a las humanas, con lo cual se evitan los problemas de rechazo por parte del organismo humano. En el Instituto de Errores Innatos del Metabolismo (IEIM de la Pontificia Universidad Javeriana se adelantan estudios conducentes a la implementación de un sistema de expresión de proteínas recombinantes en levaduras para uso clínico en enfermedades lisosomales como los síndromes de Hunter y Morquio A. Este modelo, si funciona a cabalidad, podría emplearse para la mayoría de las enfermedades lisosomales (42 en total y para otros errores innatos del metabolismo.

Enfermedad de Pompe de inicio temprano. A propósito de un caso

OpenAIRE

Grandez-Urbina, J. Antonio; Bustamante-Ubillus, Claudio; Farro-Calderon, Rossy; Linares-Alarcon, Ismael; Goyzueta-Knox, Silvana

2013-01-01

La enfermedad de Pompe es una enfermedad inusual de presentación temprana, causada por el déficit de la síntesis de α 1-4 glucosidasa ácida. Presentamos un caso de inicio insidioso descompensado evidenciándose dificultad respiratoria y cardiomiopatía. La enfermedad de Pompe es muy infrecuente, siendo el primer caso reportado en nuestro medio.

Anestesia em paciente portadora de doença de moyamoya: relato de caso Anestesia en paciente portadora de enfermedad de moyamoya: relato de caso Anesthesia in patient with moyamoya disease: case report

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Adriano Bechara de Souza Hobaika

2005-06-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: A doença de moyamoya é uma vasculopatia cerebral progressiva rara, mais freqüentemente diagnosticada em populações asiáticas, mas que também vem sendo identificada no Brasil. Durante a sua vida, pacientes portadores desta doença podem ser submetidos aos mais variados tipos de procedimentos cirúrgicos. O anestesiologista deve entender a fisiopatologia da doença e instituir as medidas peri-operatórias mais adequadas, no intuito de melhorar o prognóstico destes pacientes. RELATO DO CASO: Paciente do sexo feminino, 22 anos, com insuficiência renal crônica, portadora da doença de moyamoya, submetida à intervenção cirúrgica para instalação de fístula arteriovenosa. A anestesia foi induzida com fentanil, propofol e atracúrio e mantida com sevoflurano. Durante o procedimento, a paciente foi mantida em normocapnia e normotermia. A extubação foi realizada e a paciente transferida à sala de recuperação pós-anestésica sem complicações. CONCLUSÕES: Este artigo apresenta os cuidados anestésicos dispensados a uma paciente portadora da doença de moyamoya.JUSTIFICATIVA Y OBJETIVOS: La enfermedad de moyamoya es una vasculopatia cerebral progresiva rara, más frecuentemente diagnosticada en individuos asiáticos, y que también viene siendo identificada en Brasil. Durante su vida, pacientes portadores de esta enfermedad pueden ser sometidos a los más variados tipos de procedimientos quirúrgicos. El anestesiologista debe entender la fisiopatología de la enfermedad e instituir las medidas peri-operatorias más adecuadas, en el designio de mejorar el pronóstico de estos enfermos. RELATO DEL CASO: Paciente del sexo femenino, 22 años, insuficiencia renal crónica, portadora de la enfermedad de moyamoya, sometida a intervención quirúrgica para la instalación de fístula arteriovenosa. La anestesia fue inducida con fentanil, propofol y atracúrio y mantenida con sevoflurano. Durante el procedimiento

Endothelin-1 Mediates Brain Microvascular Dysfunction Leading to Long-Term Cognitive Impairment in a Model of Experimental Cerebral Malaria.

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Brandi D Freeman

2016-03-01

Full Text Available Plasmodium falciparum infection causes a wide spectrum of diseases, including cerebral malaria, a potentially life-threatening encephalopathy. Vasculopathy is thought to contribute to cerebral malaria pathogenesis. The vasoactive compound endothelin-1, a key participant in many inflammatory processes, likely mediates vascular and cognitive dysfunctions in cerebral malaria. We previously demonstrated that C57BL6 mice infected with P. berghei ANKA, our fatal experimental cerebral malaria model, sustained memory loss. Herein, we demonstrate that an endothelin type A receptor (ETA antagonist prevented experimental cerebral malaria-induced neurocognitive impairments and improved survival. ETA antagonism prevented blood-brain barrier disruption and cerebral vasoconstriction during experimental cerebral malaria, and reduced brain endothelial activation, diminishing brain microvascular congestion. Furthermore, exogenous endothelin-1 administration to P. berghei NK65-infected mice, a model generally regarded as a non-cerebral malaria negative control for P. berghei ANKA infection, led to experimental cerebral malaria-like memory deficits. Our data indicate that endothelin-1 is critical in the development of cerebrovascular and cognitive impairments with experimental cerebral malaria. This vasoactive peptide may thus serve as a potential target for adjunctive therapy in the management of cerebral malaria.

Palabras impertinentes. Contra el concepto de enfermedad mental.

OpenAIRE

Yolanda Gómez Fontanil; Esteban Coto Ezama

1986-01-01

Señalamos la existencia ineludible de un aspecto organizacional en toda situación, persistente e indeseable, etiquetada como de «enfermedad mental». Ese aspecto es traducible en un hacer discursivo de un colectivo de personas. Denunciamos el carácter metafórico del término «enfermedad mental» que atenúa, pero también perpetúa, la convención social de la locura: una estrategia socialmente destructora para resolver y ganar conflictos sin reconocerlos. Encontramos un campo no metafórico para la ...

Frequency of cerebral infarction and haemorrhage in the patients of stroke

International Nuclear Information System (INIS)

Shah, A.N.; Ataullah, S.

2009-01-01

Stroke is rapidly developing phenomena of symptoms and signs of focal, and at times global, loss of cerebral function with no apparent cause other than that of vascular origin. The Objective was to know the frequency of cerebral infarction and haemorrhage in one hundred patients of stroke in a period of one year. Data was collected by consecutive sampling technique. Total one hundred patients of stroke were collected for the study. They were assessed through a detailed history of hypertension, diabetes mellitus, smoking, previous stroke, transient ischemic attack (TIA), previous myocardial infarction, angina, atrial fibrillation, alcohol intake, drugs used for hypertension/diabetes mellitus. Blood pressure was recorded at arrival and 24 hours after admission. There were 70% males and 30% females. Twenty percent of the patients were in the age range of 51-60 years, 26% of the patients were in the age range of 61-70 years and 18% were in the age range of 71-80 years. Cerebral infarction was present in 72% patients while cerebral haemorrhage was present in 28% patients. Hypertension was the most common risk factor among these stroke patients. Average blood pressure was 180/100 mmHg. Cerebral infarction is the commonest form of stroke. Hypertension is the leading risk factor in stroke patients. (author)

Metabolic and circulatory evaluation of acute cerebral ischaemic accidents in man by positron emission tomography

International Nuclear Information System (INIS)

Depresseux, J.C.; Franck, G.; Van Cauwenberge, H.

1987-01-01

Positron emission tomography and oxygen-15 were used to evaluate the effects of an almitrine-raubasine combination on cerebral blood flow and oxydative metabolism in patients with acute cerebral ischaemia. In 5 patients, aged between 58 and 74 years, with cerebral ischaemic accident in the territory of the middle cerebral artery, blood flow rate, oxygen consumption and brain oxygen extraction were measured before and after a 90-min intravenous infusion of almitrine bismesilate 15 mg and raubasine 5 mg. Only one patient presented with initial relative luxury perfusion, the intensity of which was reduced by the combined treatment. The other 4 patients had focal reduction of cerebral blood flow and oxygen consumption prior to treatment. Satistical analysis conducted on three cerebral areas (epicentre of the lesion, anterior and posterior juxtalesional areas and homologous heterolateral areas) showed a significant 3.6% increase of oxygen consumption in the epicentre, both hemispheres included, and a significant increase of cerebral blood flow in all three areas (3% on the healthy side, 13% on the diseased side). No significant change in oxygen extraction was demonstrated. The authors conclude that acute almitrine-raubasine treatment has beneficial effects on the brain immediately after a cerebral vascular accident, reflecting respect of the circulation-metabolism couple [fr

Metabolic and circulatory evaluation of acute cerebral ischaemic accidents in man by positron emission tomography

Energy Technology Data Exchange (ETDEWEB)

Depresseux, J C; Franck, G., Van Cauwenberge, H.

1987-06-18

Positron emission tomography and oxygen-15 were used to evaluate the effects of an almitrine-raubasine combination on cerebral blood flow and oxydative metabolism in patients with acute cerebral ischaemia. In 5 patients, aged between 58 and 74 years, with cerebral ischaemic accident in the territory of the middle cerebral artery, blood flow rate, oxygen consumption and brain oxygen extraction were measured before and after a 90-min intravenous infusion of almitrine bismesilate 15 mg and raubasine 5 mg. Only one patient presented with initial relative luxury perfusion, the intensity of which was reduced by the combined treatment. The other 4 patients had focal reduction of cerebral blood flow and oxygen consumption prior to treatment. Satistical analysis conducted on three cerebral areas (epicentre of the lesion, anterior and posterior juxtalesional areas and homologous heterolateral areas) showed a significant 3.6% increase of oxygen consumption in the epicentre, both hemispheres included, and a significant increase of cerebral blood flow in all three areas (3% on the healthy side, 13% on the diseased side). No significant change in oxygen extraction was demonstrated. The authors conclude that acute almitrine-raubasine treatment has beneficial effects on the brain immediately after a cerebral vascular accident, reflecting respect of the circulation-metabolism couple.

Enfermedad de Hirschsprung

OpenAIRE

K A Santos-Jasso

2017-01-01

Definición
La enfermedad de Hirschsprung, megacolon congénito o agangliónico, o Aganglionosis Intestinal Congénita, es una anomalía caracterizada por la ausencia congénita de células ganglionares del sistema parasimpático de los piejos intermientéricos de Auerbach, situado entre las capas musculares, circular y longitudinal, y el submucoso de Meissner; con conducción inefectiva del peristaltismo, ocasionando obstrucción funcional (24, 37, 65, 8...

con enfermedad crónica

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María del Refugio Zavala Rodríguez

2007-01-01

Full Text Available El propósito del estudio fue determinar el grado de correlación entre los niveles de fortaleza para la salud y de ansiedad-rasgo, en unamuestra de 200 pacientes integrada por medio de muestreo no probabilístico; los criterios de inclusión fueron: adultos de ambos génerosdiagnosticados con enfermedad crónica, con estudios de enseñanza básica y orientada. El marco teórico que guió la investigación es elModelo de Adaptación de Roy. El diseño fue descriptivo, transversal, correlacional. Se utilizó el cuestionario de fortaleza de S. Pollock y laescala de autoevaluación de ansiedad-rasgo de Spielberger; los instrumentos presentaron una consistencia interna aceptable con unAlpha de Cronbach de ,852 y ,813 respectivamente. La información se recabó de cuatro instituciones de salud ubicadas en los municipiosde Tampico-Cd. Madero Tamaulipas, México. El análisis de los datos se efectuó mediante estadística descriptiva e inferencial, se utilizó elpaquete estadístico SPSS versión 13. El rango de edad que predominó fue de 45 a 64 años (54%; el 55% fue del sexo femenino, el 48%cuenta con estudios de primaria, cerca del 90% padece de una enfermedad metabólica. El coeficiente de correlación de Spearman entrela fortaleza para la salud y la ansiedad-rasgo fue significativo (Œ,570, valor Œp,000. En la mayoría de la población participante se encontróun nivel moderado tanto de fortaleza (83% como de ansiedad (73%. El análisis de regresión múltiple indicó que la relación significativaentre estas dos variables no es afectada por la edad, el género o los años de evolución de la enfermedad crónica. Los datos de este estudiomuestran evidencia de que en los pacientes con enfermedades crónicas a mayor nivel de fortaleza menor nivel de ansiedad-rasgo. Estasituación invita a desarrollar más estudios de estos fenómenos, en la disciplina de enfermería, que sirvan como sustento teórico-prácticopara el diseño o la mejora de

Role of DTI neuroimaging in diagnosis of vascular dementia

International Nuclear Information System (INIS)

Kozarova, G.; Georgieva- Penev, L.

2013-01-01

Full text: Introduction: Since its introduction more than two decades ago, Magnetic Resonance Imaging (MRI) has not only allowed for visualization of the macrostructure of the CNS, but also has been able to study dynamic processes which constitute the substrate of currently available MRI variants. Materials and methods: In this presentation, the potential role of MRI techniques, particularly DTI, for the study of the relationship between changes in the microstructural integrity of WM and cognitive impairment in the context of cerebrovascular disease and particularly the vascular dementia (VaD) are discussed. Results: While conventional Diffusion Weighted Imaging (DWI) permits a robust visualization of lesions just a few minutes after the onset of cerebral ischemia, Diffusion Tensor Imaging (DTI) measures the magnitude and direction of diffusion, leading to the characterization of cerebral white matter (WM) microstructural integrity of white matter fibers using quantitative fractionated anisotropy (DTI-FA) and tractography (DTI-TR). DTI-FA is an important technique in considering the large extension of white matter, and has been previously applied in clinical practice. DTI-TR can visualize the bundles interconnecting various regions whose interruption can cause a range of different disconnection syndromes. The method is not routinely used in clinical practice.In this presentation, the potential role of MRI techniques, particularly DTI, for the study of the relationship between changes in the microstructural integrity of WM and cognitive impairment in the context of cerebrovascular disease and particularly the vascular dementia (VaD) are discussed. Conclusion: Significant correlations between cognitive function and regional anisotropy values are an example of the potential efficacy of DTI for in vivo studies of brain connectivity in vascular neurodegenerative conditions

Multiresolution analysis of pathological changes in cerebral venous dynamics in newborn mice with intracranial hemorrhage: adrenorelated vasorelaxation

International Nuclear Information System (INIS)

Pavlov, A N; Pavlova, O N; Tuchin, V V; Semyachkina-Glushkovskaya, O V; Zhang, Y; Bibikova, O A; Huang, Q; Zhu, D; Li, P; Luo, Q

2014-01-01

Intracranial hemorrhage (ICH) is the major problem of modern neonatal intensive care. Abnormalities of cerebral venous blood flow (CVBF) can play a crucial role in the development of ICH in infants. The mechanisms underlying these pathological processes remain unclear; however it has been established that the activation of the adrenorelated vasorelaxation can be an important reason. Aiming to reach a better understanding of how the adrenodependent relaxation of cerebral veins contributes to the development of ICH in newborns, we study here the effects of pharmacological stimulation of adrenorelated dilation of the sagittal sinus by isoproterenol on the cerebral venous hemodynamics. Our study is performed in newborn mice at different stages of ICH using the laser speckle contrast imaging and wavelet analysis of the vascular dynamics of CVBF. We show that the dilation of the sagittal sinus with the decreased velocity of blood flow presides to the stress-induced ICH in newborn mice. These morphofunctional vascular changes are accompanied by an increased variance of the wavelet-coefficients in the areas of endothelial and non-endothelial (K ATP -channels activity of vascular muscle) sympathetic components of the CVBF variability. Changes in the cerebral venous hemodynamics at the latent stage of ICH are associated with a high responsiveness of the sagittal sinus to isoproterenol quantifying by wavelet-coefficients related to a very slow region of the frequency domain. The obtained results certify that a high activation of the adrenergic-related vasodilatory responses to severe stress in newborn mice can be one of the important mechanisms underlying the development of ICH. Thus, the venous insufficiency with the decreased blood outflow from the brain associated with changes in the endothelial and the sympathetic components of CVBF-variability can be treated as prognostic criteria for the risk of ICH during the first days after birth. (paper)

El concepto general de enfermedad: revisión, crítica y propuesta Tercera parte: un modelo teórico de enfermedad

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Adolfo Peña

2003-03-01

Full Text Available Se plantea el concepto de enfermedad como modelo teórico, es decir, como una representación conceptual esquemática, la cual representará la enfermedad en términos teóricos de alto grado de abstracción. Nos serviremos de conceptos matemáticos tales como los de conjunto y función, y de teorías muy generales, como la teoría general de sistemas y el materialismo emergentista.

Enfermedad de Pompe de inicio temprano: A propósito de un caso

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J. Antonio Grandez-Urbina

2013-10-01

Full Text Available La enfermedad de Pompe es una enfermedad inusual de presentación temprana, causada por el déficit de la síntesis de α 1-4 glucosidasa ácida. Presentamos un caso de inicio insidioso descompensado evidenciándose dificultad respiratoria y cardiomiopatía. La enfermedad de Pompe es muy infrecuente, siendo el primer caso reportado en nuestro medio.

White Matter Hyperintensity Volume and Cerebral Perfusion in Older Individuals with Hypertension Using Arterial Spin-Labeling

NARCIS (Netherlands)

van Dalen, J. W.; Mutsaerts, H. J. M. M.; Nederveen, A. J.; Vrenken, H.; Steenwijk, M. D.; Caan, M. W. A.; Majoie, C. B. L. M.; van Gool, W. A.; Richard, E.

2016-01-01

BACKGROUND AND PURPOSE: White matter hyperintensities of presumed vascular origin in elderly patients with hypertension may be part of a general cerebral perfusion deficit, involving not only the white matter hyperintensities but also the surrounding normal-appearing white matter and gray matter. We

L-arginine and L-NMMA for Assessing Cerebral Endothelial Dysfunction in Ischemic Cerebrovascular Disease: A Systematic Review

DEFF Research Database (Denmark)

Karlsson, William Kristian; Sørensen, Caspar Godthaab; 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 NG -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...... 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....

Diabetic microangiopathy: impact of impaired cerebral vasoreactivity and delayed angiogenesis after permanent middle cerebral artery occlusion on stroke damage and cerebral repair in mice.

Science.gov (United States)

Poittevin, Marine; Bonnin, Philippe; Pimpie, Cynthia; Rivière, Léa; Sebrié, Catherine; Dohan, Anthony; Pocard, Marc; Charriaut-Marlangue, Christiane; Kubis, Nathalie

2015-03-01

Diabetes increases the risk of stroke by three, increases related mortality, and delays recovery. We aimed to characterize functional and structural alterations in cerebral microvasculature before and after experimental cerebral ischemia in a mouse model of type 1 diabetes. We hypothesized that preexisting brain microvascular disease in patients with diabetes might partly explain increased stroke severity and impact on outcome. Diabetes was induced in 4-week-old C57Bl/6J mice by intraperitoneal injections of streptozotocin (60 mg/kg). After 8 weeks of diabetes, the vasoreactivity of the neurovascular network to CO2 was abolished and was not reversed by nitric oxide (NO) donor administration; endothelial NO synthase (eNOS) and neuronal NO synthase (nNOS) mRNA, phospho-eNOS protein, nNOS, and phospho-nNOS protein were significantly decreased; angiogenic and vessel maturation factors (vascular endothelial growth factor a [VEGFa], angiopoietin 1 (Ang1), Ang2, transforming growth factor-β [TGF-β], and platelet-derived growth factor-β [PDGF-β]) and blood-brain barrier (BBB) occludin and zona occludens 1 (ZO-1) expression were significantly decreased; and microvessel density was increased without changes in ultrastructural imaging. After permanent focal cerebral ischemia induction, infarct volume and neurological deficit were significantly increased at D1 and D7, and neuronal death (TUNEL+ / NeuN+ cells) and BBB permeability (extravasation of Evans blue) at D1. At D7, CD31+ / Ki67+ double-immunolabeled cells and VEGFa and Ang2 expression were significantly increased, indicating delayed angiogenesis. We show that cerebral microangiopathy thus partly explains stroke severity in diabetes. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Cerebral perfusion computerized tomography: influence of reference vessels, regions of interest and interobserver variability

International Nuclear Information System (INIS)

Soustiel, Jean F.; Mor, Nadav; Zaaroor, Menashe; Goldsher, Dorith

2006-01-01

There are still no standardized guidelines for perfusion computerized tomography (PCT) analysis. A total of 61 PCT studies were analyzed using either the anterior cerebral artery (ACA) or the middle cerebral artery (MCA) as the arterial reference, and the superior sagittal sinus (SSS) or the vein of Galen (VG) as the venous reference. The sizes of regions of interest (ROI) were investigated comparing PCT results obtained using a hemispheric ROI combined with vascular pixel elimination with those obtained using five smaller ROIs located over the cortex and basal ganglia. In addition, interobserver variations were explored using a standardized protocol. MCA-based measurements of cerebral blood flow (CBF) and blood volume (CBV) were in accordance with those obtained with the ACA except in 16 patients with ischemic stroke, in whom CBF was overestimated by the ipsilateral MCA. Venous maximal intensity was significantly lower with the VG when compared with the SSS, resulting in overestimation of CBF and CBV. However, in 13.3% of patients the VG ROI yielded higher maximal intensities than the SSS ROI. There was no difference in PCT results between hemispheric ROI and averaged separate ROI when vascular pixel elimination was used. Finally, interobserver variations were as high as 11% for CBF and 12% for CBV. The present results suggest that pathological rather than anatomical considerations should dictate the choice of the arterial ROI. For venous ROI, although SSS seems to be adequate in most instances, deep cerebral veins may occasionally generate higher maximal intensities and should therefore be selected. Importantly, significant user-dependency should be taken into account. (orig.)

Representación de la Enfermedad, Afrontamiento y Ajuste en los Trastornos Alimentarios

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Yolanda Quiles Marcos

2009-01-01

Full Text Available El objetivo de esta investigación es evaluar la representación de la enfermedad en pacientes con un trastorno alimentario (TA, así como su relación con el afrontamiento y el ajuste, utilizando como marco teórico el Modelo del Sentido Común de Leventhal. Método: Participaron 98 mujeres diagnosticadas de un TA. La media de edad fue 20.8 años (dt=5.61. Para evaluar la representación de la enfermedad se administró la adaptación española para los TA del Cuestionario de Percepción de la Enfermedad Revisado (IPQ-R. Resultados: Respecto a la identidad, los síntomas más señalados fueron la "pérdida de peso" (89.8% y las "alteraciones en la menstruación" (81.6%. Consideran que su enfermedad tiene una larga duración y serias consecuencias, así como que tienen control y siguiendo un tratamiento es posible su curación. El 21% de la varianza de las estrategias evitativas fue explicado por diferentes dimensiones de la representación de la enfermedad. Se confirman los efectos directos de la representación de la enfermedad sobre el ajuste, pero no los del afrontamiento. Conclusiones: Los resultados apoyan la necesidad de intervenir sobre las creencias que tienen estas pacientes sobre su enfermedad con el fin de mejorar su ajuste psicosocial.

Método de diagnóstico y/o pronóstico de enfermedades neurodegenerativas

OpenAIRE

Trullás Oliva, Ramón; Figueiro-Silva, Joana; Mihaylovich Podlesniy, Petar

2012-01-01

La presente invención se refiere al uso del ADN mitocondrial como biomarcador cuantitativo de enfermedades neurodegenerativas, preferiblemente de la enfermedad de Alzheimer, así como a un método y a un kit diagnóstico y/o pronóstico de dichas enfermedades mediante el uso de dicho biomarcador

Complications of endovascular treatment of cerebral aneurysms

Energy Technology Data Exchange (ETDEWEB)

Orrù, Emanuele, E-mail: surgeon.ema@gmail.com [Neuroradiology Department, Padua University Hospital, Via Giustiniani 2, Padua 35128 (Italy); Roccatagliata, Luca, E-mail: lroccatagliata@neurologia.unige.it [Neuroradiology Department, IRCCS San Martino University Hospital and IST, Largo Rosanna Benzi 10, Genoa 16132 (Italy); Department of Health Sciences (DISSAL), University of Genoa (Italy); Cester, Giacomo, E-mail: giacomo.cester@sanita.padova.it [Neuroradiology Department, Padua University Hospital, Via Giustiniani 2, Padua 35128 (Italy); Causin, Francesco, E-mail: francesco.causin@sanita.padova.it [Neuroradiology Department, Padua University Hospital, Via Giustiniani 2, Padua 35128 (Italy); Castellan, Lucio, E-mail: lucio.castellan@hsanmartino.it [Neuroradiology Department, IRCCS San Martino University Hospital and IST, Largo Rosanna Benzi 10, Genoa 16132 (Italy)

2013-10-01

The number of neuroendovascular treatments of both ruptured and unruptured aneurysms has increased substantially in the last two decades. Complications of endovascular treatments of cerebral aneurysms are rare but can potentially lead to acute worsening of the neurological status, to new neurological deficits or death. Some of the possible complications, such as vascular access site complications or systemic side effects associated with contrast medium (e.g. contrast medium allergy, contrast induced nephropathy) can also be encountered in diagnostic angiography. The most common complications of endovascular treatment of cerebral aneurysms are related to acute thromboembolic events and perforation of the aneurysm. Overall, the reported rate of thromboembolic complications ranges between 4.7% and 12.5% while the rate of intraprocedural rupture of cerebral aneurysms is about 0.7% in patients with unruptured aneurysms and about 4.1% in patients with previously ruptured aneurysms. Thromboembolic and hemorrhagic complications may occur during different phases of endovascular procedures and are related to different technical, clinical and anatomic reasons. A thorough knowledge of the different aspects of these complications can reduce the risk of their occurrence and minimize their clinical sequelae. A deep understanding of complications and of their management is thus part of the best standard of care.

Método de diagnóstico y/o pronóstico de enfermedades neurodegenerativas

OpenAIRE

Trullás Oliva, Ramón; Figueiro-Silva, Joana; Mihaylovich Podlesniy, Petar

2012-01-01

[ES] La presente invención se refiere al uso del ADN mitocondrial como biomarcador cuantitativo de enfermedades neurodegenerativas, preferiblemente de la enfermedad de Alzheimer, así como a un método y a un kit diagnóstico y/o pronóstico de dichas enfermedades mediante el uso de dicho biomarcador

Contribución Colombiana al Conocimiento de la Enfermedad de Morquio A

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Carlos Javier Alméciga Díaz

2012-07-01

Full Text Available La enfermedad de Morquio A o Mucopolisacaridosis IV A es un trastorno de depósito lisosomal producidapor alteración en la actividad de la enzima N-acetilgalactosamina-6-sulfato sulfatasa (GALNS encargada de la degradación de queratán y condroitin-6- sulfato. La enfermedad se caracteriza por alteraciones óseas, cardiacas y pulmonares. Aunque esta enfermedad es rara, algunos trabajos sugieren que Colombia puede ser uno de los países con mayor número de pacientes. En el presente artículo se revisará el estado actual de la enfermedad de Morquio A, haciendo especial énfasis en los aportes realizados por investigadores colombianos para su avance. Progresos importantes se han realizado en el desarrollo de nuevas técnicas de diagnóstico, modelos animales, terapia de reemplazo enzimático y terapia génica. En este último aspecto, el Instituto de Errores Innatos del Metabolismoha jugado un papel importante en el diseño y evaluación de vectores derivados de virus adenoasociados, para el desarrollo de una estrategia de terapia génica para la enfermedad de Morquio A.

Immunohistochemical study of N-epsilon-carboxymethyl lysine (CML in human brain: relation to vascular dementia

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Williams Jonathan

2007-10-01

Full Text Available Abstract Background Advanced glycation end-products (AGEs and their receptor (RAGE occur in dementia of the Alzheimer's type and diabetic microvascular disease. Accumulation of AGEs relates to risk factors for vascular dementia with ageing, including hypertension and diabetes. Cognitive dysfunction in vascular dementia may relate to microvascular disease resembling that in diabetes. We tested if, among people with cerebrovascular disease, (1 those with dementia have higher levels of neuronal and vascular AGEs and (2 if cognitive dysfunction depends on neuronal and/or vascular AGE levels. Methods Brain Sections from 25 cases of the OPTIMA (Oxford Project to Investigate Memory and Ageing cohort, with varying degrees of cerebrovascular pathology and cognitive dysfunction (but only minimal Alzheimer type pathology were immunostained for Nε-(carboxymethyl-lysine (CML, the most abundant AGE. The level of staining in vessels and neurons in the cortex, white matter and basal ganglia was compared to neuropsychological and other clinical measures. Results The probability of cortical neurons staining positive for CML was higher in cases with worse cognition (p = 0.01 or a history of hypertension (p = 0.028. Additionally, vascular CML staining related to cognitive impairment (p = 0.02 and a history of diabetes (p = 0.007. Neuronal CML staining in the basal ganglia related to a history of hypertension (p = 0.002. Conclusion CML staining in cortical neurons and cerebral vessels is related to the severity of cognitive impairment in people with cerebrovascular disease and only minimal Alzheimer pathology. These findings support the possibility that cerebral accumulation of AGEs may contribute to dementia in people with cerebrovascular disease.

La enfermedad periodontal como riesgo de enfermedades sistémicas The periodontal disease as a risk for systemic diseases

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Maritza Peña Sisto

2008-03-01

Full Text Available Se realizó una revisión bibliográfica exhaustiva acerca de la presencia de enfermedad periodontal como factor de riesgo asociado con diversas enfermedades sistémicas. Algunos autores han propuesto el nacimiento de la medicina periodontal, como nueva disciplina, para explicar estas asociaciones. Las evidencias que emergieron en el último decenio arrojaron luz sobre el lado inverso de la relación entre salud general y salud bucal, o sea, los efectos potenciales de la enfermedad periodontal sobre una amplia variedad de sistemas de órganos. En los últimos años han surgido numerosos informes basados en estudios epidemiológicos en los que las infecciones buco-dentales se asocian con enfermedades sistémicas, entre ellas alteraciones cerebrovasculares, respiratorias, diabetes mellitus y resultados adversos del embarazo, debido a los lipopolisacáridos, las bacterias gramnegativas viables del biofilm y citoquinas proinflamatorias que pueden ingresar al torrente sanguíneo e influir en la salud general y susceptibilidad a ciertas enfermedades. Se reúnen los modelos de interacción y mecanismos propuestos, además de evidencias que sustentan las teorías proclamadas, prestando especial interés a la causalidad entre ambos procesos.An exhaustive bibliographic review of the presence of the periodontal disease as a risk factor associated with diverse systemic diseases was made. Some authors have proposed the emergence of periodontal medicine as a new discipline to explain these associations. The evidences that appeared in the last decade shed light on the opposite side of the relation between general health and oral health, that is, the potential effects of the periodontal diseases on a wide range of organ systems. In the last years, several reports have been based on epidemiological studies in which the oro-dental diseases are associated with systemic diseases, such as cerebrovascular and respiratory disorders, diabetes mellitus and adverse

Terapia génica de la enfermedad de Stargardt

OpenAIRE

Martín Nieto, José

2015-01-01

El gen humano ABCA4 (=ABCR) se caracterizó en 1997 como el principal causante de la enfermedad de Stargardt, una distrofia macular hereditaria generalmente autosómica recesiva. Poco tiempo después se encontraron otras enfermedades asociadas a mutaciones en este gen, como son distrofia de conos y bastones, determinados casos de retinosis pigmentaria y un aumento de la susceptibilidad a la degeneración macular asociada a la edad. No existen tratamientos curativos para ninguna de estas distrofia...

Enfermedad de pompe: presentación de un caso

OpenAIRE

Azrak, M. Angeles; Fernández, Zulma; Peruffo, M.Virginia; Specola, Norma; Nuñez, M.; Pardo, A.

2009-01-01

Presentamos el caso de una niña de 6 meses de ascendencia china con enfermedad de Pompe diagnosticada a partir de una miocardiopatía hipertrófica biventricular e hipotonía global. En esta enfermedad el acúmulo de glucógeno lisosomal principalmente en el corazón y músculo esquelético ocasiona la mayoría de la sintomatología clínica. En esta paciente la hipotonía generalizada, macroglosia, debil...

Post-Traumatic Late Onset Cerebral Ischemia

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Gencer Genc

2014-03-01

Full Text Available Artery-to-artery emboli or occlusion of craniocervical arteries mostly due to dissection are the most common causes of ischemia after trauma. A 29 year-old male had been admitted to another hospital with loss of consciousness lasting for about 45 minutes after a hard parachute landing without head trauma three days ago. As his neurological examination and brain CT were normal, he had been discharged after 24 hours of observation. Two days after his discharge, he was admitted to our department with epileptic seizure. His neurological examination revealed left hemianopia. After observing occipital subacute ischemia at right side in brain magnetic resonance imaging (MRI, we performed cerebral angiography and no dissection was observed. Excluding the rheumatologic, cardiologic and vascular events, our final diagnosis was late onset cerebral ischemia. Anti-edema and antiepileptic treatment was initiated. He was discharged with left hemianopia and mild cognitive deficit. We suggest that it will be wise to hospitalize patients for at least 72 hours who has a history of unconsciousness following trauma.

El rol del fisioterapeuta en el manejo de la Enfermedad de Pompe

OpenAIRE

Rocío del Pilar Ruiz Agudelo; Laura Lorena Alba; Rosmary Martínez-Rueda

2015-01-01

Antecedentes: La enfermedad de Pompe está catalogada dentro del grupo de enfermedades huérfanas.  A pesar de existir tratamiento, quienes la padecen pueden sufrir secuelas relacionadas con la misma, en parte por la dificultad de un diagnóstico temprano y adecuado de la patología. Objetivo: Describir las diferentes alternativas de tratamiento fisioterapéutico para la enfermedad de Pompe. Metodología: Se realizó una revisión bibliométrica. Se consultaron en bases de datos y portales científicos...

The influence of systemic hemodynamics and oxygen transport on cerebral oxygen saturation in neonates after the Norwood procedure.

Science.gov (United States)

Li, Jia; Zhang, Gencheng; Holtby, Helen; Guerguerian, Anne-Marie; Cai, Sally; Humpl, Tilman; Caldarone, Christopher A; Redington, Andrew N; Van Arsdell, Glen S

2008-01-01

Ischemic brain injury is an important morbidity in neonates after the Norwood procedure. Its relationship to systemic hemodynamic oxygen transport is poorly understood. Sixteen neonates undergoing the Norwood procedure were studied. Continuous cerebral oxygen saturation was measured by near-infrared spectroscopy. Continuous oxygen consumption was measured by respiratory mass spectrometry. Pulmonary and systemic blood flow, systemic vascular resistance, oxygen delivery, and oxygen extraction ratio were derived with measurements of arterial, and superior vena cava and pulmonary venous gases and pressures at 2- to 4-hour intervals during the first 72 hours in the intensive care unit. Mean cerebral oxygen saturation was 66% +/- 12% before the operation, reduced to 51% +/- 13% on arrival in the intensive care unit, and remained low during the first 8 hours; it increased to 56% +/- 9% at 72 hours, still significantly lower than the preoperative level (P blood flow and oxygen delivery (P blood flow (P = .001) and hemoglobin (P = .02) and negatively correlated with systemic vascular resistance (P = .003). It was not correlated with oxygen consumption (P > .05). Cerebral oxygen saturation decreased significantly in neonates during the early postoperative period after the Norwood procedure and was significantly influenced by systemic hemodynamic and metabolic events. As such, hemodynamic interventions to modify systemic oxygen transport may provide further opportunities to reduce the risk of cerebral ischemia and improve neurodevelopmental outcomes.

Tuberculosis, una Enfermedad de Ayer, de Hoy y del Futuro

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Rafael Vargas

2013-09-01

Full Text Available La tuberculosis es una enfermedad tan antigua como la humanidad. A pesar de los avances en el conocimiento de su fisiopatología y en el desarrollo de medicamentos antituberculosos, todavía es una enfermedad común que afecta a una gran proporción de la población mundial. En los últimos años han aumentado los problemas relacionados con la morbi-mortalidad, lo cual se refleja en el incremento de la coinfección con VIH, el aumento de casos de neurotuberculosis y la mayor mortalidad en pacientes con tuberculosis. En el presente artículo se presenta una revisión de aspectos microbiológicos, epidemiológicos y clínico-terapéuticos de la enfermedad.

Toxina botulínica en parálisis cerebral infantil: resultados en 27 sujetos a lo largo de un año

OpenAIRE

Sanchez-Carpintero, R. (Rocío); Narbona, J. (Juan)

1997-01-01

Introducción y objetivos. Resultados positivos en el tratamiento de la parálisis cerebral infantil espástica con toxina botulínica, en estudios anglosajones de los últimos años, nos han llevado a iniciar este trabajo, cuyo objetivo es mostrar nuestra experiencia con la toxina en el tratamiento de esta enfermedad, establecer sus indicaciones, analizar los resultados obtenidos y plantear posibles aplicaciones futuras. Material y métodos. Incluimos 10 pacientes hemipléficos y 17 dipl...

Establishment of modified reversible regional cerebral ischemic models

International Nuclear Information System (INIS)

Ji Xunming; Ling Feng; Zhao Xiqing; Xuan Yun; Wang Yueqin; Ling Xiaolan; Chang Hongjun; Zhang Zhiping

2005-01-01

Objective: Modifying the method of establishing reversible middle cerebral ischemic models in rats for improvement of the stability and rate of success, so as to raise the reliability of cerebral ischemic study. Methods: Sixty male Wistar rats were randomly divided into two groups, modified and control groups, 30 rats in each group. The method of silicone- tipping on one end of the nylon suture was used to modify the establishment of embolus, and tip-heating method was used to establish the traditional embolus with all the other steps of the procedure just the same. The Zea Longa 5 scoring scale was used to estimate the neurological deficiency while TTC staining method was used to measure and calculate the volume of cerebral infarction. The percentage of successful models with 3-4 grade scorings and the coefficient of the variations of cerebral infarct volume were used to estimate the stability of the models. Results: The rate of success of establishment models in the modification group was significantly higher in comparing with the traditional group (93% vs 60%, χ 2 =9.32, P=0.002). The percentage of model establishment with 3-4 grade neurological scores in modification group was higher than that in the traditional group 96.4% vs 61.2%, χ 2 =9.51, P=0.002). The cerebral infarct volume in modification group and traditional group were (4.1450±0.5019) cm 3 and (3.8435 ± 0.8164) cm 3 , and the coefficients of variation were 12.01% and 21.24% respectively, which indicated that the stability of models was significantly higher in modification group than in the traditional one. Conclusions: The rates of success and stability of the models for reversible focal cerebral ischemia made by the modification method were significantly improved, with decreasing the cost of model creation and increasing the accuracy of study of ischemic cerebral vascular disease. (authors)

Cerebral Embolic Activity in a Patient during Acute Crisis of Takayasu's Arteritis

Science.gov (United States)

Nogueira, Ricardo de Carvalho; Bor-Seng-Shu, Edson; Marchiori, Paulo Eurípedes; Teixeira, Manoel Jacobsen

2012-01-01

Takayasu's arteritis is a disease that affects large vessels and may cause neurological symptoms either by stenoses/occlusions or embolisms from vessels with an inflammatory process. Transcranial Doppler (TCD) ultrasound can provide useful information for diagnosis and monitoring during the active phase of the disease. Cerebral embolic signals can be detected by TCD and have been considered a risk factor for vascular events. We report a patient in whom TCD ultrasound was used to monitor cerebral embolic signals during the active phase of the disease. This case report suggests that embolic activity in Takayasu's arteritis may represent disease activity, and its monitoring may be useful for evaluating the response to therapy. PMID:22379479

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

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Pamela L Lutsey

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

Diabetes mellitus en el paciente con enfermedad renal avanzada

OpenAIRE

R. Verner Codoceo, Dr.

2010-01-01

La diabetes mellitus 2 (DM 2) y la enfermedad renal crónica (ERC) son considerados problemas de salud pública a nivel mundial. Los pronósticos de ambas enfermedades están estrechamente relacionados, por lo que las acciones terapéuticas son complementarias. Un buen control glicémico revierte las alteraciones renales en sus etapas iniciales disminuyendo el deterioro microangiopático ya su vez el intento de obtener un control óptimo de glicemias requiere conocer y tratar las alteraciones provoca...

Intra-artery thrombolytic therapy for acute ischemic cerebral infarction

International Nuclear Information System (INIS)

Du Wei; Shao Chengmin; Wang Jianlin; Lei Jin; Jia Fan; Cao Lanfang; Chai Ruchang; Su Wei; Gu Jinchuan

2004-01-01

Objective: To evaluate the clinical effects of intra-arterial thrombolytic therapy for acute ischemic cerebral infarction and analyze the factors influencing the clinical prognosis. Methods: 32 patients were treated with intra-arterial thrombolysis using urokinase (median dose, 65 x 10 4 U) within 2-20 hours, after the onset. The patient's condition was assessed by neurologists using National Institutes of Health Stroke Scale (NIHSS) score right at the admission. Clinical outcome was assessed after 3 months and graded as good for Modified Rankin Scale (MRS) scores of 0 to 3 and poor for MRS scores of 4 or 5 and death. Results: Follow up cerebral angiography of 14 cases treated within 6 hours after onset showed complete/partial recanalization in 13 cases. Other 18 patients whose treatment started beyond 6 hours after onset out-came with complete/partial in 7. 20 (62.5%) of the 32 patients had good out-come, 12(37.5%) had poor outcome and two patients(9.4%) died. Cerebral hemorrhage occurred in 2 of the 32 patients. Good outcome was associated with an initial NIHSS score of <20 (P<0.01) and vascular recanalization (P<0.025). Recanalization was more likely to be obtained if thrombolysis began within 6 hours (P<0.05). Conclusion: Intra-arterial thrombolysis is a safe and effective therapy for acute ischemic cerebral infarction. (authors)

Tuberculosis como enfermedad ocupacional Tuberculosis as occupational disease

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Alberto Mendoza-Ticona

2012-06-01

Full Text Available Existe evidencia suficiente para declarar a la tuberculosis como enfermedad ocupacional en diversos profesionales especialmente entre los trabajadores de salud. En el Perú están normados y reglamentados los derechos laborales inherentes a la tuberculosis como enfermedad ocupacional, como la cobertura por discapacidad temporal o permanente. Sin embargo, estos derechos aún no han sido suficientemente socializados. En este trabajo se presenta información sobre el riesgo de adquirir tuberculosis en el lugar de trabajo, se revisan las evidencias para declarar a la tuberculosis como enfermedad ocupacional en trabajadores de salud y se presenta la legislación peruana vigente al respecto.There is enough evidence to declare tuberculosis as an occupational disease among healthcare workers. In Peru, there are regulations granting employment rights regarding tuberculosis as an occupational disease, such as healthcare coverage for temporary or permanent disability. However, these rights have not been sufficiently socialized. This study presents information on the risk of acquiring tuberculosis in the workplace, and a review of the evidence to declare tuberculosis as an occupational disease among health care workers, presenting the current Peruvian law related.

Call-Fleming Syndrome (Reversible Cerebral Artery Vasoconstriction and Aneurysm Associated with Multiple Recreational Drug Use

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Doniel Drazin

2013-01-01

Full Text Available Drug abuse represents a significant health issue. Evidence suggests that recreational drug use has a direct effect on the cerebral vasculature and is of greater concern in those with undiagnosed aneurysms or vascular malformations. The authors report a case of thunderclap headache with a negative head CT and equivocal lumbar puncture after a drug-fueled weekend. The patient underwent diagnostic cerebral angiogram which demonstrated multisegmental, distal areas of focal narrowing of the middle, anterior, posterior, and posterior inferior cerebral artery and an incidental aneurysm. It is often difficult to determine the exact origin of symptoms; thus we were left with a bit of a chicken or the egg debate, trying to decipher which part came first. Either the aneurysm ruptured with associated concomitant vasospasm or it is a case of Call-Fleming syndrome (reversible cerebral artery vasoconstriction with an incidental aneurysm. The authors proposed their management and rationale of this complex case.

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

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ELCIO JULIATO PIOVESAN

1999-06-01

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

Pruebas diagnósticas en la enfermedad por reflujo gastroesofágico

OpenAIRE

Remes-Troche, José María

2013-01-01

En la actualidad la enfermedad por reflujo gastro esofágico (ERGE) no es una enfermedad simple y se tiene que considerar como una enfermedad heterogénea y multi-sintomática por lo que no hay una prueba estándar de oro. La decisión de que prueba utilizar, cuando utilizarla y cuál será su ganancia en el diagnóstico depende de varios factores. Para la evaluación estructural, la videoendoscopia se considera la prueba ideal ya que permite establecer la ausencia o presencia de erosiones y de compli...

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)

Twelve years nuclear medicine - results and outlook - illustrated by 7414 cerebral scintigrams

International Nuclear Information System (INIS)

Klaeger, R.

1981-01-01

It is a fact that until the invention of computerized tomography, scintiscanning was an excellent method for diagnosing tumours, metastases, vascular processes, inflammations and traumatic lesions. Now even the differential diagnosis is possible, and also follow-up examinations are often carried out. On the basis of the 7414 considered and studied scintigrams we came to the positive result that in most cases with deliberate questions directed to specific facts, this examination procedure was applied. Scintigraphy can be considered as the predecessor of computerized tomography. With respect to differential diagnostics the following can be said: Cerebral scintigraphy measures in cases of cerebral lesions only masses, whereas the computerized tomograph permits within certain limits even the differentiation between lesion and perifocal oedema. The tomographs of the last generation even differentiate between white and grey cerebral substance. Nevertheless, the residual domaine of scintigraphy remains untouched: the patients with non-focal symptoms, including headaches, general behaviour disorders and psychiatric processes. (orig./MG) [de

Cardiopatías y enfermedades periodontales: ¿existen evidencias de asociación?

OpenAIRE

Jiménez Beato, Gema; Machuca Portillo, Guillermo

2005-01-01

Las enfermedades cardiovasculares representan una de las principales causas de muerte en las sociedades desarrolladas. Estas enfermedades no sólo son importantes por la mortalidad que generan, sino por la gran cantidad de individuos afectados y en tratamiento que han de soportar los sistemas de salud de los distintos países. De ahí que la detección precoz de los factores de riesgo conducentes a desencadenar estas enfermedades haya sido vista como el mecanismo más eficaz p...

Enfermedad inflamatoria intestinal y celiaquía : componente genético y farmacogenética

OpenAIRE

Medrano de Dios, Luz María

2014-01-01

La enfermedad inflamatoria intestinal (EII) y la enfermedad celiaca (ECe) son dos enfermedades mediadas por el sistema inmunológico con afectación intestinal crónica. En los últimos años los avances en los estudios genéticos (GWAS) han permitido identificar un amplio número de variantes asociadas a estas enfermedades (163 loci en EII y 40 en ECe). A pesar de ello, existe un porcentaje de heredabilidad aún por descubrir (“heredabilidad perdida”) en la que hemos centrado este trabajo. Comenzamo...

Análisis de las patologías con mayor prevalencia en las Unidades Móviles de Rehabilitación y Fisioterapia de la provincia de Almería Analysis of the most prevalent disorders in home-rehabilitation and physiotherapy units in the province of Almería (Spain

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Remedios López-Liria

2012-06-01

Full Text Available Objetivos: Describir las patologías de mayor prevalencia en 1753 pacientes derivados a las Unidades Móviles de Rehabilitación y Fisioterapia. Método: Estudio descriptivo transversal. Las variables analizadas fueron la edad, el sexo, el diagnóstico principal, la capacidad funcional (Índice de Barthel, los objetivos fisioterapéuticos, las técnicas de tratamiento y el número de sesiones realizadas. Resultados: Los diagnósticos principales fueron secuelas por inmovilización (29%, fracturas de cadera (16,5%, accidente vascular cerebral (13,7%, prótesis de rodilla (11,9% y cadera (4,7%, enfermedad pulmonar obstructiva crónica (2,6% y enfermedad de Alzheimer (2,4%. Los Índices de Barthel iniciales más bajos se obtuvieron en Alzheimer, accidente vascular cerebral y secuelas por inmovilización; el más alto se obtuvo en los pacientes intervenidos de prótesis de rodilla. El proceso que necesitó mayor número de sesiones para su recuperación fue el accidente vascular cerebral. Conclusiones: Se confirman ganancias positivas entre el Índice de Barthel inicial y el final tras el tratamiento rehabilitador para cada proceso descrito, con una mayor independencia funcional del paciente.Objectives: To describe the most prevalent disorders in 1753 patients referred to home rehabilitation and home physiotherapy units. Method: We carried out a cross-sectional descriptive study. The variables analyzed were age, gender, main diagnosis, functional capacity (Barthel Index, physiotherapeutic objectives, the treatment applied and the number of sessions. Results: The main diagnoses were immobilization effects (29%, hip fracture (16.5%, stroke (13.7%, knee replacement (11.9%, hip replacement (4.7%, chronic obstructive pulmonary disease (2.6%, and Alzheimer's disease (2.4%. The lowest Barthel Index was obtained in Alzheimer's disease, stroke and immobilization effects and the highest in patients with knee replacement. The process requiring the highest

The role of nuclear magnetic resonance imaging in the diagnosis of intracranial vascular malformation

International Nuclear Information System (INIS)

Ford, C.S.; Buonanno, F.S.; Kistler, J.P.; Johnson, K.A.

1987-01-01

Intracranial vascular malformations (ICVMs) usually present with seizures or intracranial hemorrhage. Less commonly, they cause headaches and transient or progressive focal neurologic deficits. Consecutive autopsy data show, however, that asymptomatic ICVMs are actually many times more common than symptomatic ones. Asymptomatic ICVMs are often never detected. Recognition of ICVMs is further hindered by the fact that cerebral angiography and computed tomography are normal in many cases. A review is given of the cerebral angiograms, and the CT and nuclear magnetic resonance (NMR) scans in a group of patients with ICVM to study the role of NMR in making the diagnosis. 5 refs.; 1 figure

Vascular malformations in pediatrics; Vaskulaere Erkrankungen bei Neugeborenen, Saeuglingen und Kindern

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Reith, W. [Abteilung fuer Neuroradiologie, Radiologische Universitaetsklinik Homburg/Saar (Germany); Abteilung fuer Neuroradiologie, Radiologische Universitaetsklinik, 66421, Homburg/Saar (Germany); Shamdeen, M.G. [Kinderklinik, Universitaetsklinikum Homburg/Saar (Germany)

2003-11-01

Vascular malformations are the cause of nearly all non-traumatic intracranial hemorrhage in children beyond the neonatal stage. Therefore, any child presenting with spontaneous intracranial hemorrhage should be evaluated for child abuse and for vascular malformations. Intracerebral malformations of the cerebral vasculature include vein of Galen malformations, arteriovenous malformation (AVM), cavernomas, dural arteriovenous fistulas, venous anomalies (DVA), and capillary teleangiectasies. Although a few familial vascular malformation have been reported, the majority are sporadic. Clinical symptoms, diagnostic and therapeutic options are discussed. (orig.) [German] Vaskulaere Malformationen sind die haeufigste Ursache einer intrakraniellen Blutung im Saeuglings- und Kindesalter. Deswegen sollte jedes Kind mit einer intrakraniellen Blutung auf eine vaskulaere Malformation und Kindesmisshandlung untersucht werden. Intrazerebrale Gefaessmalformationen beinhalten Vena-Galeni-Anomalien, arteriovenoese Malformationen (AVM), Kavernome, durale arteriovenoese Fisteln, kapillaere Teleangiektasien und venoese Anlagevarianten (DVA). Obwohl einige familiaere Gefaessmalformationen beschrieben sind, tritt die ueberwiegende Mehrzahl spontan auf. Die Klinik, Diagnostik und therapeutischen Optionen werden diskutiert. (orig.)

La enfermedad de Graves, signos y síntomas

OpenAIRE

Young, P.; Finn, B. C.; Bruetman, J. E.

2007-01-01

La enfermedad de Graves es la causa más común de hipertiroidismo, es de patogenia autoinmune. Se distingue clínicamente de otras formas de hipertiroidismo por la presencia de bocio difuso, oftalmopatía y ocasionalmente mixedema pretibial. En este artículo describimos la vida y obra de Robert Graves, realizando posteriormente una revisión de los signos y síntomas de la enfermedad. En el mundo de la medicina actual, en donde la tecnología juega un rol preponderante, queremos recordar la importa...

Atrofia muscular espinal tipo 1: enfermedad de Werdnig-Hoffmann

OpenAIRE

Zárate-Aspiros, Romeo; Rosas-Sumano, Ana Beatriz; Paz-Pacheco, Alberto; Fenton-Navarro, Patricia; Chinas-López, Silvet; López-Ríos, José Antonio

2013-01-01

Introducción. Las atrofias musculares espinales de la infancia son enfermedades neuromusculares hereditarias, autosómicas, recesivas, caracterizadas por la degeneración de las neuronas motoras del asta anterior de la médula espinal. La atrofia muscular espinal tipo I (enfermedad de Werdnig-Hoffmann) es la forma más severa. Se inicia in útero o durante los primeros meses de vida. La muerte suele ocurrir antes de los dos años de edad. Caso clínico. Lactante de 6 meses de edad que ingresa al Ser...

Leopoldo María Panero: enfermedad mental y literatura

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Sánchez Bustos, Sergio Augusto

2012-01-01

Un estudio de la vida y obra del poeta Leopoldo María Panero, ha sido realizado, acentuando la búsqueda de caracterizaciones, textos, representaciones y su devenir biográfico de manera de configurar un discurso y una biografía de Leopoldo María Panero, enfatizando en sus textos la búsqueda de relaciones con la enfermedad mental. Mediante el estudio de la vida y obra del poeta se pretende contribuir a comprender sin prejuicios y críticamente los usos sociales del concepto de enfermedad mental ...

Manual Aspiration Thrombectomy in Patients with Acute Stroke-Related Calcified Cerebral Emboli.

Science.gov (United States)

Koh, Esther; Kwak, Hyo Sung; Chung, Gyung-Ho

2017-10-01

The aim of this study was to evaluate the effectiveness of mechanical aspiration thrombectomy (MAT) in patients with acute ischemic stroke from calcified cerebral emboli. Procedural results were reviewed for acute stroke patients with clinically neurological deficits who underwent recanalization from October 2012 through September 2015. Initial imaging studies and cerebral angiography were analyzed. Of the total number of patients with acute stroke, 5 patients were confirmed to have acute ischemic stroke by calcified cerebral emboli. On initial brain computed tomographic imaging, all patients showed small, dense single calcifications in the middle cerebral artery with no definitive ischemic low-density lesions (M1: 3, M2: 2, mean size: 4.8 mm). All patients had angiographic findings of filling defects from calcified emboli. Four patients had good collateral flow and two had continuous distal flow. All patients underwent MAT using a Penumbra catheter (Penumbra Inc., Alameda, CA). MAT did not remove calcified emboli in all patients. Two patients with good collateral flow had favorable functional outcomes (modified Rankin Scale score ≤2). Four patients had diffuse calcification in the aortic arch, carotid artery, and aortic valve. Cerebral angiography supports a diagnosis of stroke when calcified cerebral emboli have contrast-filling defects and a degree of vascular occlusion. However, in this study, MAT was not an effective treatment for patients with calcified cerebral emboli because of hardness of the calcified plaque and packing into the arterial lumen. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Hemopexin induces neuroprotection in the rat subjected to focal cerebral ischemia.

Science.gov (United States)

Dong, Beibei; Cai, Min; Fang, Zongping; Wei, Haidong; Zhu, Fangyun; Li, Guochao; Dong, Hailong; Xiong, Lize

2013-06-10

The plasma protein hemopexin (HPX) exhibits the highest binding affinity to free heme. In vitro experiments and gene-knock out technique have suggested that HPX may have a neuroprotective effect. However, the expression of HPX in the brain was not well elucidated and its expression after cerebral ischemia-reperfusion injury was also poorly studied. Furthermore, no in vivo data were available on the effect of HPX given centrally on the prognosis of focal cerebral ischemia. In the present study, we systematically investigated expression of HPX in normal rat brain by immunofluorescent staining. The results showed that HPX was mainly expressed in vascular system and neurons, as well as in a small portion of astrocytes adjacent to the vessels in normal rat brain. Further, we determined the role of HPX in the process of focal cerebral ischemic injury and explored the effects of HPX treatment in a rat model of transient focal cerebral ischemia. After 2 h' middle cerebral artery occlusion (MCAO) followed by 24 h' reperfusion, the expression of HPX was increased in the neurons and astrocytes in the penumbra area, as demonstrated by immunohistochemistry and Western blot techniques. Intracerebroventricular injection of HPX at the onset of reperfusion dose-dependently reduced the infarct volumes and improved measurements of neurological function of the rat subjected to transient focal cerebral ischemia. The neuroprotective effects of HPX sustained for up to 7 days after experiments. Our study provides a new insight into the potential neuroprotective role of HPX as a contributing factor of endogenous protective mechanisms against focal cerebral ischemia injury, and HPX might be developed as a potential agent for treatment of ischemic stroke.

Enfermedades Autoinmunes, tratamiento con Trichuris suis y otros helmintos

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Iñigo Pallardo Fernández

2015-01-01

Full Text Available Objetivos: La "Hipótesis de la Higiene" postula sobre los efectos inmunomoduladores inducidos por agentes infecciosos en los seres humanos. El objetivo principal de este trabajo es indagar sobre las evidencias de esa hipótesis y sobre sus aplicaciones en el campo del tratamiento de las enfermedades autoinmunes, haciendo especial hincapié tanto en los mecanismos de acción en los que se basan estas aplicaciones como en los resultados reales obtenidos. Además analizará la posible evolución de estas terapias, especialmente a la sombra de las controversias éticas que surgen de la aplicación de estos tratamientos en relación a si es lícito causar una infección para curar otra patología, como es el caso que nos ocupa. Resultados: Actualmente existen resultados prometedores de ensayos clínicos sobre terapias helmínticas aplicadas al tratamiento de enfermedades autoinmunes como son la enfermedad de Crohn y la colitis ulcerosa, resumidos en el apartado de resultados de este artículo. Igualmente prometedora es la gran variedad de ensayos clínicos que actualmente están en curso sobre la aplicación de la terapia helmíntica al tratamiento de diversas patologías en las que está involucrado el sistema inmunológico, como son: asma, rinitis alérgica, artritis reumatoide, esclerosis múltiple, diabetes Mellitus tipo I, encefalomielitis autoinmune, obesidad, autismo, etc que han llevado a identificar cuáles son los parásitos indicados en el tratamiento de este amplio espectro de enfermedades. Sin embargo es necesario indicar que no todos los helmintos son inmunorreguladores y, por lo tanto útiles en el tratamiento de estas enfermedades y que, los que lo son, no son útiles en el tratamiento de todas las enfermedades de origen inmunológico sino que presentan una marcada especificidad. Es más, la utilidad de éstos presenta una variabilidad importante, no sólo dependiente de la enfermedad de origen inmunológico a tratar, sino tambi

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.

Intraoperative Cerebral Glioma Characterization with Contrast Enhanced Ultrasound

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Francesco Prada

2014-01-01

Full Text Available Background. Contrast enhanced ultrasound (CEUS is a dynamic and continuous modality providing real-time view of vascularization and flow distribution patterns of different organs and tumors. Nevertheless its intraoperative use for brain tumors visualization has been performed few times, and a thorough characterization of cerebral glioma had never been performed before. Aim. To perform the first characterization of cerebral glioma using CEUS and to possibly achieve an intraoperative differentiation of different gliomas. Methods. We performed CEUS in an off-label setting in 69 patients undergoing surgery for cerebral glioma. An intraoperative qualitative analysis was performed comparing iCEUS with B-mode imaging. A postprocedural semiquantitative analysis was then performed for each case, according to EFSUMB criteria. Results were related to histopathology. Results. We observed different CE patterns: LGG show a mild, dotted CE with diffuse appearance and slower, delayed arterial and venous phase. HGG have a high CE with a more nodular, nonhomogeneous appearance and fast perfusion patterns. Conclusion. Our study characterizes for the first time human brain glioma with CEUS, providing further insight regarding these tumors’ biology. CEUS is a fast, safe, dynamic, real-time, and economic tool that might be helpful during surgery in differentiating malignant and benign gliomas and refining surgical strategy.

Spaceflight on the Bion-M1 biosatellite alters cerebral artery vasomotor and mechanical properties in mice

Science.gov (United States)

Sofronova, Svetlana I.; Tarasova, Olga S.; Gaynullina, Dina; Borzykh, Anna A.; Behnke, Bradley J.; Stabley, John N.; McCullough, Danielle J.; Maraj, Joshua J.; Hanna, Mina; Muller-Delp, Judy M.; Vinogradova, Olga L.

2015-01-01

Conditions during spaceflight, such as the loss of the head-to-foot gravity vector, are thought to potentially alter cerebral blood flow and vascular resistance. The purpose of the present study was to determine the effects of long-term spaceflight on the functional, mechanical, and structural properties of cerebral arteries. Male C57BL/6N mice were flown 30 days in a Bion-M1 biosatellite. Basilar arteries isolated from spaceflight (SF) (n = 6), habitat control (HC) (n = 6), and vivarium control (VC) (n = 16) mice were used for in vitro functional and mechanical testing and histological structural analysis. The results demonstrate that vasoconstriction elicited through a voltage-gated Ca2+ mechanism (30–80 mM KCl) and thromboxane A2 receptors (10−8 − 3 × 10−5 M U46619) are lower in cerebral arteries from SF mice. Inhibition of Rho-kinase activity (1 μM Y27632) abolished group differences in U46619-evoked contractions. Endothelium-dependent vasodilation elicited by acetylcholine (10 μM, 2 μM U46619 preconstriction) was virtually absent in cerebral arteries from SF mice. The pressure-diameter relation was lower in arteries from SF mice relative to that in HC mice, which was not related to differences in the extracellular matrix protein elastin or collagen content or the elastin/collagen ratio in the basilar arteries. Diameter, medial wall thickness, and medial cross-sectional area of unpressurized basilar arteries were not different among groups. These results suggest that the microgravity-induced attenuation of both vasoconstrictor and vasodilator properties may limit the range of vascular control of cerebral perfusion or impair the distribution of brain blood flow during periods of stress. PMID:25593287

PSA (:30) Enfermedades diarreicas (Diarrheal Diseases)

Centers for Disease Control (CDC) Podcasts

2017-10-25

Este anuncio de servicio público de 30 segundos habla sobre cómo prevenir las enfermedades diarreicas después de una emergencia.  Created: 10/25/2017 by Centers for Disease Control and Prevention (CDC).   Date Released: 10/25/2017.

Cerebral CT of ischaemic lesions

Energy Technology Data Exchange (ETDEWEB)

Aulich, A

1981-11-25

The diagnosis of stroke must first be established by clinical examination. CT has proved useful for confirmation of the diagnosis and provides a global intracranial picture of morphological changes in cerebral vascular diseases. A hemorrhage can be recognized with certainty at the first CT examination as the cause of the stroke, but in the detection of a lesion due to ischemia an important role is played by the correct choice of the time of examination, and in some cases also of the check-up with contrast medium. The differential diagnosis between infarct in the acute stage and encephalitis or gliomas of low-grade malignity can be difficult. A decision can often only be made after a series of examinations. Postmalacial conditions are often difficult to differentiate from defects due to other causes, such as hemorrhage, head injury, postoperative states and after encephalitis. A knowledge of the anamnesis and the clinical findings is indispensable for CT evaluation. In assessing the prognosis before vascular surgery on the extracranial brain-supplying vessels the performance of a CT examination should be advised. A warning is given against the use of CT as a screening method.

Biomarcadores en enfermedades relacionadas con el sistema nervioso

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Elso Manuel Cruz Cruz

2014-12-01

Full Text Available El estudio de biomarcadores, o marcadores biológicos para el diagnóstico y seguimiento al tratamiento de enfermedades, constituye referente frecuente en la literatura científica biomédica actual. Se realizó una revisión bibliográfica empleando los recursos disponibles en la red Infomed, específicamente Ebsco, The Cochrane Librery, PubMed, Hinari y SciELO, a través de los cuales se accedieron a las bases de datos: MEDLINE, Academic Search Premier, MedicLatina y Scopus. Se recopilaron varios artículos científicos, donde se hace referencia al empleo de biomarcadores en el diagnóstico de enfermedades relacionadas con el sistema nervioso. El factor de crecimiento endotelial, la inmunoglobulina G (IgG y el sistema arginina - óxido nítrico - citrulina, se refieren como indicadores prematuros de la hemorragia subaracnoidea. La disminución del amiloide beta y el aumento de las concentraciones de proteína tau en el líquido cefalorraquídeo, se cuentan entre los biomarcadores más prometedores e informativos que indiquen precozmente el Alzheimer y otras enfermedades neurodegenerativas. Estos mismos marcadores se comportan de manera contraria a nivel plasmático. La copeptina es un biomarcador fácilmente medible, que refleja la situación de estrés a la que está sometido el organismo y se propone su uso en el diagnóstico del síndrome de Burnout; además, niveles aumentados de α-amilasa y cromogranina A (CgA salivales pueden también ser utilizadas como indicadores de este síndrome. Se logró recoger en este artículo un compendio de ejemplos de marcadores biológicos, utilizados en el diagnóstico de enfermedades relacionadas de alguna forma con el sistema nervioso