Cerebrovascular diseases
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Cerebrovascular diseases · Jan 2008
Cardiac arrhythmias after subarachnoid hemorrhage: risk factors and impact on outcome.
Serious cardiac arrhythmias have been described in approximately 5% of patients after subarachnoid hemorrhage (SAH). The aim of this study was to identify the frequency, risk factors and clinical impact of cardiac arrhythmia after SAH. ⋯ Clinically important arrhythmias, most often atrial fibrillation or flutter, occurred in 4% of SAH patients. Arrhythmias are associated with an increased risk of cardiovascular comorbidity, prolonged hospital stay and poor outcome or death after SAH, after adjusting for other predictors of poor outcome.
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Cerebrovascular diseases · Jan 2008
Multicenter StudyInfluence of antiplatelet pre-treatment on the risk of symptomatic intracranial haemorrhage after intravenous thrombolysis.
The influence of antiplatelet agents (AP) in the development of a symptomatic intracranial haemorrhage (SICH) after intravenous rt-PA is not well known. We assessed the hypothesis that pre-treatment with AP may increase that risk. ⋯ Pre-treatment with AP non-significantly increases the risk of SICH and therefore this antecedent should not be a contraindication for intravenous thrombolysis.
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Cerebrovascular diseases · Jan 2008
Controlled Clinical TrialCerebral autoregulation dynamics in acute ischemic stroke after rtPA thrombolysis.
To investigate whether there is: (1) a specific temporal course of cerebral dysautoregulation in acute ischemic stroke, and (2) a separate detrimental effect of recombinant tissue plasminogen activator (rtPA) on autoregulation dynamics in this situation. ⋯ Cerebral autoregulation is increasingly impaired, mainly on the affected side, over the first 5 days of major ischemic stroke after unsuccessful rtPA thrombolysis. It is bilaterally preserved in minor stroke after successful rtPA thrombolysis, indicating no separate detrimental effect of rtPA on the cerebral autoregulatory mechanism.
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Cerebrovascular diseases · Jan 2008
ReviewUse of 31P magnetic resonance spectroscopy to study the effect of cortical magnesium and energy metabolism after subarachnoid hemorrhage.
Flow metabolism coupling ensures adequate cerebral oxygenation. When subarachnoid hemorrhage (SAH) occurs, the flow metabolism coupling lost its balance and results in cerebral ischemia and infarction second to cortical magnesium and energy metabolism alternation. During chronic vasospasm, change in cortical energy metabolism is coupled with change in cerebral blood flow after SAH. ⋯ (31)P MRS data, combined with other MRI sequences, provide a comprehensive assessment of both structural and functional deficits and a guidance on clinical therapy for SAH.
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Cerebrovascular diseases · Jan 2008
Comparative StudyVisual grading system for vasospasm based on perfusion CT imaging: comparisons with conventional angiography and quantitative perfusion CT.
The purpose of this study was to compare simple visual grading of perfusion CT (PCT) maps to a more quantitative, threshold-based interpretation of PCT parameters in the characterization of presence and severity of vasospasm. ⋯ We propose a user-friendly visual grading system for PCT maps in patients with suspected vasospasm. This visual approach compares favorably to the results of DSA. Sensitive MTT maps should be used for screening, and specific CBF maps for confirmation of vasospasm.