Stroke; a journal of cerebral circulation
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Although there is much speculation regarding the source of bleeding in patients with subarachnoid hemorrhage when no angiographic abnormality is found, little direct evidence has been obtained to document a cause. We report two cases of stroke in the distribution of a perforating or lenticulostriate artery occurring at the time of angiogram-negative subarachnoid hemorrhage. ⋯ These observations suggest that in some cases of angiogram-negative subarachnoid hemorrhage the source of blood may be a small artery that is obliterated at the time of hemorrhage. This observation provides an explanation for the low rate of rehemorrhage among patients with angiogram-negative subarachnoid hemorrhage.
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Although there are various methods of determining neurological prognosis after cardiopulmonary resuscitation, the final outcome of patients often remains unclear for quite a long time. ⋯ Proton magnetic resonance spectroscopy and short-latency evoked potentials are of great benefit in the prognostic evaluation after cardiopulmonary resuscitation.
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Multicenter Study Clinical Trial
Current emergency department management of stroke in Houston, Texas.
This study describes emergency department (ED) management of stroke in Houston, Tex, in 1992 to identify delays and deficiencies in recognition and management of stroke patients in various hospital subtypes and to quantitate the impact of a rapid response stroke team. ⋯ Transport, initial evaluation, and ED care of acute stroke patients are currently slow and often inexpert in all types of hospitals. A stroke team can speed initial ED management.
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Comparative Study
Carotid diameter and blood flow velocities in cerebral circulation in hypertensive patients.
The recent development of noninvasive techniques for the evaluation of the carotid arteries has focused attention on the study of arterial wall thickness to identify early lesions of vessels in patients at high risk for atherosclerosis, such as those with hypercholesterolemia, diabetes mellitus, and hypertension. ⋯ These results indicate that in addition to the degenerative changes of the common carotid wall, the diameter of the carotid artery and the relation to parietal stress show an early impairment in patients with uncomplicated hypertension.
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Comparative Study
Distinguishing carotid artery pseudo-occlusion with color-flow Doppler.
This study was undertaken to determine the impact of color-flow Doppler on the accuracy of noninvasive carotid imaging for distinguishing an internal carotid artery pseudo-occlusion (string sign) from a complete occlusion. ⋯ The addition of color-flow Doppler to the duplex evaluation of the extracranial carotid circulation improves the accuracy of distinguishing carotid pseudo-occlusion from the occluded internal carotid artery and may obviate the need for arteriography to identify patients with this critical level of carotid stenosis.