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  • 1995-1999  (4)
  • Cerebral blood flow  (2)
  • subarachnoid hemorrhage  (2)
  • angioplasty  (1)
  • Tomography
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  • 1
    ISSN: 1437-2320
    Keywords: Aneurysm ; angioplasty ; balloon catheter, intravascular surgery ; subarachnoid hemorrhage ; vasospasm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Of 455 cases of ruptured intracranial aneurysm treated with radical surgery from January 1987 to March 1992, 19 cases with high grade symptomatic vasospasm were treated by percutaneous transluminal balloon angioplasty (PTA). The indication for PTA was high grade symptomatic vasospasm which does not respond to conservative medical treatment. Of the 36 segments of vasospastic arteries, severe vasospams (angiographical constriction more than 50% of diameter on admission) was observed in 67%. PTA dialted these vasospastic arteries significantly (diameter of more than 75% of diameter on admission) in 83%. Follow up angiography revealed neither recurrence of vasospasm nor chronic atherosclerotic changes. Clinical improvement within 24 hours after PTA was observed in 63% of cases (7 of 17 cases with consciousness disturbance, 5 of 16 cases with motor weakness and one of 7 cases with aphasia). Outcomes at the time of discharge were excellent in 10 cases, good in 3, fair in 4, and lethal in 2. SPECT study before and after PTA confirmed improvement of cerebral blood flow in 3 out of 5 cases investigated. PTA for high grade symptomatic vasospasm after subarachnoid hemorrhage is considered an effective treatment method for the patient who does not respond to medical therapy. Immediate improvement of angiographical and clinical findings were frequently observed immediately after PTA. Exact indication and timing of PTA should be postulated after much more cases have been treated with this methal.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1437-2320
    Keywords: Angioplasty ; balloon catheter ; subarachnoid hemorrhage ; surgical treatment ; vasospasm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In spite of recent advancements in the management of ruptured aneurysm, there are still controversies as to how to threat the patients in serious conditions, one of these concerning whether to operate patients admitted with symptomatic vasospasm (vasospasm on admission) and when. While early surgery may protect patient from further rupturing, it may also increase risk of worsening by inducing much more vasospasm. Four cases of severe vasospasm associated with aneurysmal subarachnoid hemorrhage (SAH) were reported. All of these cases showed symptomatic and angiographical vasospasm on their admission 3–11 days after initial attack of SAH. All cases had a preoperative clinical grading using Hunt & Kosnik of IV, and were treated by early surgery with clipping followed by percutaneous balloon angioplasty (PTA) immediately after clipping. Two cases returned to their previous occupations, while one case remained bed ridden and one died in spite of therapy. Early surgery in this series actually prevented further rupturing, but it is not clear whether PTA immediately after clipping may prevent further deterioration by progression of vasospasm. For selected cases especially those with reversible ischemia, this combined treatment may offer more favorable results than late surgery with conservative medical care. Further investigation is necessary to support the validity of this therapy.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1437-2320
    Keywords: Cerebral blood flow ; cerebral embolism ; fibrinolysis ; HM-PAO ; ischemic flow threshold ; SPECT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To clarify the indications for local fibrinolytic therapy for acute cerebral embolism, correlation among initial regional cerebral blood flow (rCBF) abnormalities, recanalization timing, and computed tomographic scan (CT) findings two days later were evaluated in 17 cases. All cases included had embolic occlusion of middle cerebral or internal carotid arteries which showed no abnormal findings on initial CT corresponding to the acute events but did show abnormal CBF reduction on initial single photon emission computed tomography (SPECT). Relative rCBF was evaluated as the percentage radioisotope counts in the region of interest (ROI) of the affected side against the corresponding ROI in the unaffected contralateral side. Within 6 hours from onset, there was a tendency towards reversed time dependent tolerance of cortical infarction with residual relative rCBE. Hemorrhagic transformation was observed in one case whose relative rCBF was 35% or less. In 10 patients whose occluded arteries were not recanalized within 6 hours, cortical areas with residual relative rCBF of 70% or more did not develop infarction. In conclusions, a pre-therapeutic rCBF study using SPECT is considered to be mandatory: cases with moderate ischemia involving the cortex with residual relative rCBF of between 35% and 70% may be good candidates for local fibrinolytic therapy.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1439-6327
    Keywords: Dynamic exercise ; Cerebral blood flow ; Flow resistance ; Resistance index ; Pulsatility index
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cerebral blood volume flow and flow velocity have been reported to increase during dynamic exercise, but whether the two increase in parallel and whether both increases occur as functions of exercise intensity remain unsettled. In this study, blood flow velocity in the common carotid artery was measured using the Doppler ultrasound method in eight healthy male students during graded treadmill exercise. The exercise consisted of stepwise progressive increases and decreases in exercise intensity. The peak intensity corresponded to approximately 85% of maximal oxygen consumption. During this exercise, the heart rate (f c), mean blood pressure (BP) in the brachial artery and mean blood flow velocity (νcc) in the common carotid artery increased as functions of exercise intensity. At the peak exercise intensity, (f c), BP and νcc increased by 134.5%, 20.5% and 51.8% over the control levels before exercise (P 〈 0.01), respectively. The resistance index (RI) and pulsatility index (PI) were determined from the velocity profile and were expected to reflect the distal cerebral blood flow resistance. The RI and PI increased during the graded exercise, but tended to decrease at the highest levels of exercise intensity. As νcc increased with increases in exercise intensity it would be expected that cerebral blood flow would also increase at these higher intensities. It is also suggested that blood flow velocity in the cerebral artery does not proportionately reflect the cerebral blood flow during dynamic exercise, since the cerebral blood flow resistance changes.
    Type of Medium: Electronic Resource
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