[Diagnosis and therapy of acute arterial occlusion of the extracranial cerebral arteries].
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Biomedical subjects
Publications and source records attributed to B Reichmuth.
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One hundred and six selected patients (71 women, 35 men) suffering from transient cerebral ischaemic attacks (TIA) when aged less than 50 years received a comprehensive diagnostic assessment. Patients were classified into three subgroups, into which 9% could be assigned in approximately equal proportions. These were group A; TIA patients with tetanic syndrome (median age of first TIA 32 years, mainly female, 3.2 attacks per year and changing vascular area); group B; TIA patients with migraine (median age of first TIA 26 years, no predominance of male or female sex, 2.0 attacks per year and mostly in the same vascular area); group C: TIA patients suffering from premature arteriosclerosis (median age of first TIA 40 years, no predominance of male or female sex. 0.8 attacks per year and mostly in the same vascular area). Magnesium (P less than 0.001) and calcium (P less than 0.05) in plasma were reduced in group A, and magnesium (P less than 0.05) in group B, versus group C. The increased propensity to vasoconstriction appears to be an important pathogenic factor, particularly in group A, but also in group B.
Simultaneous computer tomographic and cerebrospinal fluid dynamics examinations in patients with high-pressure hydrocephalus, normal pressure hydrocephalus and cerebral atrophic processes are presented and discussed. Exclusive CT and MR examinations do not allow a differentiation of patients with normal pressure hydrocephalus and patients with cerebral atrophy. In the simultaneous examinations the morphological substrate during the intrathecal infusion test is represented.
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In order to avoid or diminish secondary cerebral damage in the treatment of the craniocerebral trauma the removal of disturbances of the microcirculation is of decisive importance to the course of the disease and the prognosis. The microcirculation is essentially determined by rheological factors such as haematocrit, plasma viscosity, aggregation and fluidity of erythrocytes. Rheological aspects should be included to a greater extent than has been done until now in the basic therapy of traumatic cerebral blood supply disturbances. If this is not done, an important therapeutic reserve is not made use of. In our opinion isovolaemic haemodilution is a practical method. The application of cerebroselective calcium antagonists appears to be reasonable as well.
The cerebral compression of a patient with posttraumatic hydrocephalus was measured intraventricularly, and an intrathecas infusion test was made simultaneously with computed tomography. Substractive computed tomography pictures show that continuously increasing volume does not imply uniform enlargement of the ventricular system, the cornua of the lateral ventricles in particular exhibiting a frontal increase in size.
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