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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 112 (1991), S. 13-18 
    ISSN: 0942-0940
    Keywords: Cerebral ischaemia ; vertebral artery reconstruction ; vertebral to subclavian transposition ; vertebrobasilar insufficiency
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary For vascular reconstruction in cases of atherosclerotic stenosis at the origin of the vertebral artery, we use vertebral to subclavian artery transposition. We discuss the advantages and effectiveness of such treatment based on a study of 32 cases. We have experienced neither surgical mortality nor morbidity and the outcome at the time of discharge has been favourable. Follow-up revealed no deaths, however, three cases exhibited symptoms of cerebral ischaemia. One had a supratentorial completed stroke, and the other two hat TIA or RIND, but without any notable lesion in the angiograms. There were no cases of cerebral infarction of the posterior fossa. We believe that this method should be the first choice for treatment of cases without lesions of the subclavian artery for the following reasons: serious operative complications have not been encountered, surgical invasion is minimal, temporary occlusion of the common carotid artery is unnecessary, the operation can be done by occluding only the vertebral artery, and unlike various bypass operations, anastomosis is required at only one location and is consequently technically uncomplicated. Following anastomosis the cerebral blood pathway is physiological.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 0942-0940
    Keywords: Cerebral ischaemia ; mannitol ; fluorocarbon emulsion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Using the “canine model of complete ischemic brain regulated with a perfusion method” in which it is possible to control the degree of blood flow to a cerebral hemisphere via a perfusion pump, the effects of mannitol (which acts as a free radical scavenger) and fluorcarbon emulsion (FC) (which has 0.1 μm of average particle size and a high oxygen-carrying capacity) on cerebral ischaemia were investigated. After pretreatment with the drugs, blood flow was reduced via the pump to 1/10 the normal state and 1 hour later, return to a normal state allowed. Subsequent changes in electrical activity were observed and the effects of the drugs evaluated. In the control group, no recovery of electrical activity was seen, but in the animals treated with either mannitol or FC, incomplete, yet distinct recovery was apparent. In the animals administered mannitol together with FC, however, marked recovery was evident. These experimental results indicate that the combined administration of mannitol and FC is effective in protecting the brain from cerebral ischaemia.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 0942-0940
    Keywords: Cerebral ischaemia ; phenytoin ; free radical scavengers
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To study the therapeutic effect of phenytoin on cerebral ischaemia and confirm whether or not the effectiveness of phenytoin could be enhanced by combined administration with free radical scavengers, twenty-five dogs were subjected to ischaemia, using the “canine model of the completely ischaemic brain regulated with a perfusion method”. Five animals served as untreated controls, fifteen received treatment with several doses of phenytoin and five were treated with 10mg/kg phenytoin, 2g/kg mannitol and 30mg/kg vitamin E. These drugs were administered prior to the production of ischaemia. After one hour ischaemia, cerebral blood flow was restored and the recovery of electrical activity of the brain and the degree of brain swelling were observed for three hours. With regard to the recovery of the EEG, the higher the administered dosage, the better was the degree of recovery of the EEG. And the group which was treated with a combination of phenytoin, mannitol and vitamin E exhibited remarkable recovery of the EEG. With regard to the degree of brain swelling, a similar doserelated suppressive effect was seen in the phenytoin-treated groups. Furthermore, in the combination therapy group, brain swelling was attenuated significantly. Based on these results, it is concluded that phenytoin has a protective effect in cerebral ischaemia and it shows its most remarkable effect when given together with radical scavengers, such as mannitol and vitamin E.
    Type of Medium: Electronic Resource
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