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At least 415 records · Page 23Linked to original sources
PubMed1994

[Non-hemodynamic vascular risk in the patient with arterial hypertension. The effects of medical therapy].

Systemic hypertension is associated with an increased risk of cerebrovascular and coronary events. The exact role of antihypertensive therapy in reversing or reducing the incremental risk is still a matter of debate. Stroke in hypertension can be large vessel disease (atherothrombotic ischemic stroke), or small vessel disease resulting in lacunar lesions or an intracerebral haemorrhage. In the major trials evaluating the benefits of antihypertensive therapy the entire excess risk of stroke (35 to 45%) can be reversed in 3-5 years. Data on coronary events are less clearcut but the most recent metanalyses including data from trials in elderly patients show that the reduction in coronary events is larger and more significant than in previous metanalyses (approximately 16%). ACE-inhibitors and calcium channel blockers have many potential advantages over diuretics and beta-blockers. Their role is under investigation in ongoing clinical trials.

Cerebrovascular Circulation↗
PubMed1976

Tomographic images of blood pool and perfusion in brain and heart.

A whole-body positron-emission transaxial tomograph (PETT III) was used to image the cross-sectional distribution of 13NH3 and 11CO-hemoglobin in the human brain and heart. Carotid and intravenous bolus injections of 13NH3 in the rhesus monkey had shown that 13NH3 is efficiently extracted by the brain and clears from it slowly (half-time, 40-50 min for carotid injections and 60-70 min for intravenous injections). The intravenous tomographic images in humans showed an excellent relationship between 13NH3 uptakes in the cortex, subcortical white matter, cerebellum, and brain stem and normal blood perfusion or flow in these structures. Cerebral lesions with high (metastasis) and low (stroke) blood flows showed correspondingly high and low uptakes of 13NH3. Large- and small-vascular structures of the brain were also clearly seen in 11CO-hemoglobin tomographic images. Normal myocardium and the ventricular chambers were well defined, and a transmural anterior myocardial infarct was clearly shown. The effective combination of positron transaxial tomography and compounds labeled with positron-emitters provides a safe new method for quantitatively imaging hemodynamic and physiologic functions of selected organs with good tomographic image quality.

Animals↗
PubMed1996

Vascular MR contrast enhancement in cerebrovascular disease.

PURPOSE: To determine the significance of vascular enhancement in stroke patients with and without permanent neurologic deficit. METHODS: We prospectively studied two groups of patients with spin-echo MR imaging before and after injection of gadopentetate dimeglumine. In the patients in group 1 (12 women, 22 men; age range, 32 to 76 years), who had permanent neurologic deficit caused by recent ischemic brain infarction, we obtained 3 to 13 serial MR images during follow-up examination. Group 2 consisted of 26 patients (14 women, 12 men; age range, 54 to 81 years) with transient neurologic deficit caused by angiographically proved high-grade stenosis or occlusion of the internal carotid artery. RESULTS: Vascular enhancement was present in 59% of patients in group 1 and in 65% of patients of group 2. In group 1, the frequency of vascular enhancement declined steadily over several weeks, but it was still present in single cases even after 3 months. Vascular enhancement correlated positively with the extent of brain infarction in group 1 and with the degree of carotid stenosis in group 2. CONCLUSION: Vascular enhancement as shown by MR imaging may herald ischemic brain infarction and could persist over several weeks in areas that show collateral flow after infarction has occurred.

Adult↗
PubMed1996

[Surgical outcome of aortic arch aneurysm in the institutes registered with Tokai Cardiovascular Surgeons Conference].

In aortic arch replacement, cerebral protection has been achieved by means of deep hypothermia associated with complete circulatory arrest, selective cerebral perfusion (SCP), or retrograde cerebral perfusion (RCP). We describe our results of the investigation with questionnaire to the institutes registered with the Tokai Cardiovascular Surgeons Conference in 1994. In 23 institute, surgical procedures of aortic arch were performed for 333 cases from 1989 to 1994, which were consisted of 126 cases of true atherosclerotic aneurysm and 206 cases of dissecting aneurysm. Cerebral disorders occurred in 11% (37/333). The incidence of cerebral disorders was significantly higher in patients with RCP methods (16%, 18/111), than SCP method (7%, 15/204, p < 0.05). In patients who had dissecting aneurysm, the incidence of cerebral disorders was 6% with SCP method (7/126) and 21% with RCP methods (14.66), respectively (p < 0.05). The cerebral disorders with RCP methods were most frequently caused by the malperfusion. In atherosclerotic cases, the causes of the cerebral disorders were mainly the embolic disorders.

Adult↗