Stroke; a journal of cerebral circulation
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Comparative Study
Diabetes mellitus as a risk factor for death from stroke. Prospective study of the middle-aged Finnish population.
High blood pressure is the most important risk factor for stroke. It is also known that diabetic patients are at increased risk of both hypertension and stroke. The aim of this study was to assess the independent effect of diabetes as a risk factor for stroke. Results from the previous studies of this question have been somewhat inconclusive. ⋯ Diabetic subjects have a very high risk of death from stroke, particularly women. Our data also suggest that the duration of diabetes is an important factor contributing to the risk of stroke.
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The compromise of cerebrovascular autoregulation in severe occlusive carotid artery disease depends on the functional capacity of collateral pathways. In previous reports correlating hemodynamic disturbances with collateral pathways, collateral blood supply was often evaluated by invasive cerebral angiography. In this study noninvasive transcranial Doppler ultrasound was used to determine both collateral pathways and vasomotor reactivity. ⋯ The presence of an ophthalmic artery pathway may provide the first evidence of disturbed vasomotor reactivity. The use of cerebral angiography to evaluate collateral pathways must be considered carefully since transcranial Doppler ultrasound is a reliable noninvasive alternative.
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Comment Letter Comparative Study
The prognosis of familial versus nonfamilial aneurysmal subarachnoid hemorrhage.
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In past studies, cerebral outcome after normothermic cardiac arrest of 10 or 12.5 minutes in dogs was improved but not normalized by resuscitative (postarrest) treatment with either mild hypothermia or hypertension plus hemodilution. We hypothesized that a multifaceted combination treatment would achieve complete cerebral recovery. ⋯ After normothermic cardiac arrest of 11 minutes in dogs, resuscitative mild hypothermia plus cerebral blood flow promotion can achieve functional recovery with the least histological brain damage yet observed with the same model and comparable insults.
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Comparative Study Clinical Trial Controlled Clinical Trial
Comparative study of power-based versus mean frequency-based transcranial color-coded duplex sonography in normal adults.
Power-based transcranial color-coded duplex sonography (p-TCCD) is a new ultrasonic method that has advantages compared with frequency-based TCCD (f-TCCD), since it is essentially independent of the angle of insonation, not subject to aliasing, and has a better signal-to-noise ratio. The purpose of this study was to evaluate the ability of p-TCCD to visualize flow in cerebral parenchyma and to compare the advantages, limitations, and reliability of velocity measurements of p-TCCD versus f-TCCD in the major basal cerebral arteries of normal subjects. ⋯ Compared with f-TCCD, p-TCCD had no important advantages but had several unimportant limitations in a study of normal adults with adequate ultrasonic windows.