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Biomedical subjects

I C Matjucha

Publications and source records attributed to I C Matjucha.

5 recordsLinked to original sources
PubMed2001

Retinal ischemia and embolism. Etiologies and outcomes based on a prospective study.

OBJECTIVES: To identify the most likely mechanisms of retinal ischemia and embolism in a hospital-referred population, and to determine the frequency of recurrent vascular events during the 3-month period following initial presentation. METHODS: Consecutive patients presenting to 2 tertiary medical centers and their outpatient clinics were prospectively enrolled over a 22-month period. Eligible patients presented with histories of transient or permanent monocular visual loss, or had evidence of asymptomatic retinal embolism on routine ophthalmological examination. They underwent a rapid and standardized evaluation that included imaging studies as well as blood tests, and follow-up was obtained at 1 and 3 months. RESULTS: Seventy-seven patients were enrolled. Enrollment diagnoses consisted of amaurosis fugax (n = 32), asymptomatic retinal embolism (n = 34), and central or branch retinal artery occlusion (n = 11). Eight different presumed etiologies of retinal artery distribution embolism or hypoperfusion were identified. Extracranial internal carotid artery occlusion or more than 50% stenosis was observed in 17/77 (22.1%) cases, making it the largest etiologic subgroup. Uncommon but treatable conditions were identified in 8/77 (10.4%) patients, and an etiologic diagnosis could not be made in 35/77 (45.5%) patients. Recurrent events occurred in, respectively, 14/77 (18.2%) and 6/73 (8.2%) patients at the 1- and 3-month follow-ups. They included 2 infarcts and 2 deaths; ischemic events of the retina were more common than those involving the brain. CONCLUSION: Severe stenosis of the extracranial internal carotid artery is the most common identified condition associated with retinal ischemia and embolism, but a variety of other, potentially treatable, conditions can be diagnosed if appropriate and specific evaluations are conducted. The frequency of recurrent vascular ischemic events is highest during the 1st month of follow-up and decreases during the 2nd and 3rd months. Recurrences range from relatively innocuous episodes of amaurosis fugax to vascular death.

Adult↗
PubMed1998

Carotid endarterectomy in a patient with anterior ischemic neuropathy.

A case of anterior ischemic optic neuropathy (AION) associated with 90% stenosis of the ipsilateral internal carotid artery (ICA) and diminished blood flow through the ophthalmic artery was studied. After carotid endarterectomy (CEA), the patient showed subjective and measurable improvement in vision and increased ophthalmic artery flows. This observation supports the role for screening carotid duplex scanning and transcranial Doppler in patients with AION. Early CEA in patients with associated ipsilateral ophthalmic artery hypoperfusion may improve visual outcome.

Blood Flow Velocity↗
PubMed1998

Cerebral microembolism in patients with retinal ischemia.

BACKGROUND AND PURPOSE: We investigated the frequency of cerebral microembolism detected by transcranial Doppler ultrasonography in patients with clinical evidence of retinal ischemia, including transient monocular blindness, central and branch retinal artery infarction, and ischemic oculopathy, and assessed its correlation with carotid artery stenosis. METHODS: Records of 331 consecutive patients examined during a 47-month period at the Neurovascular Laboratory were reviewed. Of the original 453 intracranial arteries, 186 middle cerebral arteries (MCAs) satisfied qualifying criteria that excluded patients with cardiac embolic sources. Forty-five MCAs ipsilateral to the symptomatic eye constituted the study group. The control group consisted of 141 asymptomatic MCAs. Microembolus detection studies were performed on transcranial Doppler instruments equipped with special software, and the degree of carotid artery stenosis was measured by cerebral or MR angiography or by color duplex studies. RESULTS: Microembolism was detected in 40.0% of study MCAs and 9.2% of controls (P < 0.001). In the study group, microembolic signals were detected in 61.9% of MCAs tested within a week of symptom onset and 20.8% of those tested afterward (P < 0.001). Severe (> or = 70%) carotid stenosis or occlusion was more frequent in the study group (P < 0.001). Microembolic signals were detected in 25.3% and 11.2%, respectively, of MCAs distal to carotid arteries with 70% to 100% and 0% to 69% stenosis (P = 0.013). CONCLUSIONS: In patients without cardiac embolic sources, cerebral microembolism is frequently present on the side of retinal ischemia, particularly during the week after onset of symptoms. It is often associated with severe stenosis or occlusion of the ipsilateral carotid artery.

Adult↗
PubMed1996

Migraine.

Current research has focused on several aspects of migraine. Epidemiologic studies have described the general health characteristics of migraineurs. Case reports of unusual manifestations of migraine abound, and advances in the application of neurologic imaging offer the promise of prompt, efficient diagnosis of unusual vascular headaches. Investigations into physiologic and biochemical parameters of migraine continue to advance theories of pathogenesis. Finally, as a wide range of therapeutic modalities continue to be used in these diseases, the efficacy, complications, and relative costs of different therapies are discussed.

Combined Modality Therapy↗