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Biomedical subjects

V Di Piero

Publications and source records attributed to V Di Piero.

54 records · Page 3Linked to original sources
PubMed1989

Acetazolamide effects on cerebral blood flow in acute reversible ischemia.

Cerebral blood flow (CBF) was studied in 4 patients with acute reversible ischemia (RIND). To test the ischemic areas' vasoreactivity, CBF was measured by the Xenon-133 inhalation method, before and after acetazolamide injected intravenously. At the baseline CBF study, 3 patients presented hypoperfused areas while one patient had increased CBF over the affected hemisphere. The acetazolamide test, showed in this latter case a "steal phenomenon" while in the other 3 an increase of perfusion was evidenced, in areas of normal flow, as well as in areas with reduced flow. These results suggest that in the acute phase of patients with RIND, when brain regions of hypoperfusion and neurological signs are still present, the vasomotor response may be preserved.

Acetazolamide↗
PubMed1989

Positron emission tomography: applications in the study of lacunar infarcts.

Positron emission tomography (PET) has opened new fields of investigation on clinicometabolic correlations in subcortical infarcts. Functional changes occurring in structurally unaffected brain regions represent one of the most interesting aspects of PET application. So far, the only one PET study on lacunar infarcts has not shown any significant cortical metabolic abnormality. Correlations between distribution and severity of cortical metabolic depression, the size and site of lesion and clinical symptoms still have to be better elucidated.

Cerebral Infarction↗
PubMed1989

Myocardial ischemia during stroke: scintigraphic demonstration.

In a 74-year old female, admitted to the Acute Stroke Unit for a cerebral reversible ischemic attack, we investigated the occurrence of ischemic alterations on ECG, recorded during an acute relapse, using 99mTc (MIBI) myocardial scintigraphy. Scintigrams showed a transient anteroseptal and inferior hypoperfusion. This is the first direct demonstration of myocardial ischemia occurring during stroke.

Aged↗
PubMed1988

Remote effects of subcortical cerebrovascular lesions: a SPECT cerebral perfusion study.

The remote effects of small unilateral cerebrovascular lesions confined to subcortical structures were evaluated by single photon emission computerized tomography (SPECT) and a CBF tracer, I-123 HIPDM. A CBF study was performed in 34 patients presenting with subcortical stroke either in the acute or in the chronic stages. Twenty-one of the 34 patients showed areas of cortical hypoperfusion ipsilateral to the subcortical lesion. In 14 patients, asymmetry of perfusion was also observed at the cerebellar level, perfusion being significantly reduced in the cerebellar hemisphere contralateral to the lesion. There was no correlation between the degree and extension of these remote effects and the type of stroke (ischemic or hemorrhagic), the patency of cerebral arteries, or the size and site of the lesion by transmissive computerized tomography (TCT). Subcortical hematomas showed a correlation between occurrence of remote effects and time interval from the onset of stroke, occurring more frequently in the acute phase. A correlation was observed between cortical and cerebellar remote effects and the severity of clinical presentation. The causes of remote effects are still unclear and have been extensively debated. Our data indicate that there is a relationship of remote effect to the neurological status. It is possible to show, by noninvasive, low-cost methods, remote CBF effects after stroke that may contribute to the assessment of brain functional impairment.

Acute Disease↗
PubMed1988

Technetium-99m HM-PAO-SPECT study of regional cerebral perfusion in early Alzheimer's disease.

Regional cerebral perfusion was evaluated by single photon emission computed tomography (SPECT) using technetium-99m hexamethylpropyleneamine oxime ([99mTc]HM-PAO) in sixteen patients with Alzheimer's disease (AD) in early clinical phase and in 16 healthy elderly controls. In all patients transmission computed tomography (TCT) and/or magnetic resonance imaging (MRI) did not show focal brain abnormalities. Relative to normal subjects, AD patients showed significant reductions in cortical/cerebellar activity ratio: cortical perfusion was globally depressed with the largest reductions in frontal and posterior temporo-parietal cortices. Asymmetries of relative perfusion between cerebral hemispheres were also demonstrated when language was affected or visuospatial functions were unevenly impaired. In patients with early AD, SPECT provides functional information to be compared with clinical and psychometric data.

Aged↗
PubMed1987

Cerebral arterial spasm after subarachnoid hemorrhage. A case report with SPECT and iodine-123 HIPDM.

Cerebral arterial spasm following subarachnoid hemorrhage can be responsible for secondary neurological deficits and can influence history, prognosis, and results of surgical treatment. The demonstration of vasospasm can be important for therapy. The use of I-123 HIPDM and SPECT in evaluating regional cerebral blood flow showed the effects on cerebral perfusion of diffuse arterial spasm in a case of subarachnoid hemorrhage and its recovery. There was a parallel with clinical neurological status.

Female↗
PubMed1987

Long-term noninvasive single photon emission computed tomography monitoring of perfusional changes after EC-IC bypass surgery.

The rCBF was evaluated using I-123 HIPDM and single photon emission computed tomography (SPECT) on 14 patients undergoing extracranial-intracranial (EC-IC) bypass surgery because of internal carotid artery (ICA) occlusion. Before surgery, all patients showed cortical areas of hypoperfusion over the affected cerebral hemisphere. Shortly after EC-IC bypass a rCBF increase was observed in six patients. However, at the 6 and 12 month follow-ups, with angiographic control of bypass patency, rCBF studies did not show any significant rCBF change. Long-term noninvasive tomographic monitoring of perfusion changes occurring after EC-IC bypass surgery failed to show a long-lasting improvement in perfusion.

Adult↗
PubMed1987

Crossed cerebellar diaschisis in patients with cerebral ischemia assessed by SPECT and 123I-HIPDM.

Crossed cerebellar diaschisis (CCD) was investigated in a series of 59 patients (34 completed strokes and 25 reversible ischemic attacks, RIAs) using single photon emission computerized tomography (SPECT) with 123I-HIPDM as a cerebral blood flow (CBF) indicator. CCD was present in 17 (50%) of the patients with completed stroke and in 6 (24%) of the patients with RIAs. CCD was significantly correlated to the clinical severity (p less than 0.001) and to the extension of the supratentorial lesion (p less than 0.05). However, CCD was also recorded in 3 out of 16 patients with normal neurological examination and CT scan, suggesting that a 'functional' hemispheric disturbance may be sufficient to produce a remote effect on the contralateral cerebellar hemisphere. Time elapsed between the clinical onset and SPECT study was not critical, since CCD was recorded in the acute as well as in chronic studies. Follow-up SPECT studies showed that CCD disappeared in 5 out of 18 patients after a successful extra-intracranial bypass, while a spontaneous recovery was observed in only one of 16 nonsurgical patients.

Adult↗
PubMed1986

Sequential assessment of regional cerebral blood flow, regional cerebral blood volume, and blood-brain barrier in focal cerebral ischemia: a case report.

Regional CBF (rCBF) and regional cerebral blood volume (rCBV) were evaluated by N,N,N'-trimethyl-N'-(2)-hydroxy-3-methyl-5-[123I]iodobenzyl-1, 3-propanediamine-2 HCl- and 99mTC-labeled red blood cells, respectively, and single-photon emission computerized tomography (SPECT) in a patient with focal cerebral ischemia. Sequential transmission computerized tomography (TCT) and SPECT functional data were compared with clinical findings to monitor the pathophysiological events occurring in stroke. A lack of correlation between rCBF-rCBV distributions and blood-brain barrier (BBB) breakdown was found in the acute phase. In the face of more prolonged alteration of BBB, as seen by TCT enhancement, a rapid evolution of transient phenomena such as luxury perfusion was shown by SPECT studies. Follow-up of the patient demonstrated a correlation between the neurological recovery and a parallel relative improvement of the cerebral perfusion.

Adult↗
PubMed1983

Mitral valve prolapse as a risk factor for TIA. A study with echocardiography and dynamic ECG.

The present study has been devoted to the analysis of 120 patients presenting with reversible focal cerebral ischemia without conventional signs of cardiopathy and/or relevant atherosclerotic disease. In 77% of the patients vascular risk factors, such as hypertension or hyperlipemia, were present. In 23% of the patients, no abnormal finding was discovered at clinical, hematochemical and cardiological examinations. In these patients a further cardiological evaluation was performed with echocardiography. Dynamic electrocardiography was performed in 52 patients. Echocardiography and dynamic electrocardiography revealed the occurrence of 6 cases of mitral valve prolapse (MVP), 2 cases of frequent premature ventricular beats, and 1 proximal atrial arrhythmia. All 6 cases of MVP were detected in the subgroups of patients without vascular risk factors. In our patients younger than 45 years, the relative frequency of MVP attains 21.5%. This study confirms that MVP has to be regarded as a risk factor for focal cerebral ischemia in young patients.

Adult↗
PubMedDate not supplied

Functional MRI, drugs, and poststroke recovery.

Stroke is the first cause of disability in industrialized countries. Thus, understanding the mechanisms of poststroke recovery appears to be crucial in improving motor performance and reducing disability in stroke patients. Strategies through which brain restores lost functions after ischemic lesions are numerous. The mechanisms underlying poststroke recovery, known as cerebral plasticity, are so far hypothetical. However, functional magnetic resonance imaging (fMRI) studies recently have provided new insights in to stroke recovery. This article sketches out the mechanisms that are thought to underly recovery and focuses on fMRI experimental studies that have investigated the influence of a number of drugs on functional recovery. Functional MRI is a valuable tool in understanding functional recovery and may help to disclose new therapeutical approaches.

Animals↗