bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spatial distribution of carotid intimal-medial thickness as measured by B-mode ultrasonography.
Authors: Espeland M A , Hoen H , Byington R , Howard G , Riley W A , Furberg C D 
Published: June 2011

Measurements of intimal-medial thickness (IMT) of the carotid artery by B-mode ultrasonography are widely used as markers of atherosclerosis. This report describes empirical features of these measurements to characterize their distribution within arterial wall segments, to explore their potential as study outcome measures, and to examine their links with traditional risk factors for cardiovascular disease.
Sequential transverse measurements of IMT in the carotid arteries were made in 899 participants from the Asymptomatic Carotid Artery Progression Study (ACAPS) at baseline. Data from 17 intrasegment sites in each of 12 arterial wall segments were used to describe patterns of thickness and visualization and to characterize cross-sectional area, severity, and roughness/irregularity by the intrasegment averages, maxima, and SDs of IMT, respectively.
Serial correlations of IMT measurements indicated localized and diffuse features of disease. The spatial distribution of IMT had two dominant features: overall mass and mass relative to roughness. The validity of these features was demonstrated by their correlation to known risk factors for carotid atherosclerosis: body mass index, age, high-density lipoprotein cholesterol, systolic blood pressure, smoking, and sex.
Both the mean and maxima of intrasegment measurements appear to be good candidates for use in clinical studies. B-mode ultrasonography has validity for the description of IMT roughness and shape. Both of these features are linked to cardiovascular risk factors, which supports the multifaceted nature of atherosclerosis.
Fibrin contributes to microvascular obstructions and parenchymal changes during early focal cerebral ischemia and reperfusion.
Authors: Okada Y , Copeland B R , Fitridge R , Koziol J A , del Zoppo G J 
Published: June 2011

Ischemic cerebral injury is associated with activation of the blood coagulation cascade. To elucidate the contribution of fibrin formation to microvascular injury during focal cerebral ischemia and reperfusion, we have studied the time course and the localization of fibrin deposition in cerebral microvessels and the surrounding tissues during ischemia/reperfusion in a well-described nonhuman primate model.
Cerebral tissues from adolescent male baboons were examined after 2-hour middle cerebral artery occlusion (n = 3) and after 3 hours of middle cerebral artery occlusion and 1-hour (n = 6), 4-hour (n = 3), and 24-hour (n = 4) reperfusion; tissues from control primates (n = 3) also were examined. Fibrin deposition was detected by immunohistochemical techniques using the fibrin-specific monoclonal antibody MH-1. The number and size distribution of microvessels associated with fibrin were quantified by video-imaging microscopy.
Fibrin was associated with microvessels only in the ischemic zone where severe neuronal injury was documented, its frequency increasing with the reperfusion period (F4,26 = 3.80, P < .05). Extravascular fibrin deposition was significantly increased by 24-hour reperfusion compared with the other subjects (P < .05). Preischemia infusion of the anti-tissue factor monoclonal antibody TF9-6B4 resulted in significant reduction of intramicrovascular fibrin (P < .038 versus no intervention) at 1-hour reperfusion but had no effect on extravascular fibrin deposition.
These results suggest that microvascular fibrin deposition accumulates in a time-dependent manner during focal cerebral ischemia/reperfusion and that exposure of focal cerebral ischemia/reperfusion and that exposure of plasma to perivascular tissue factor is partially responsible for occlusion formation. During ischemia the large plasma protein fibrinogen extravasates and interacts with parenchymal tissue factor, forming significant extravascular fibrin by 24 hours of reperfusion.
Cerebral hyperemia in MELAS.
Authors: Gropen T I , Prohovnik I , Tatemichi T K , Hirano M 
Published: June 2011

The pathophysiology of stroke-like episodes in MELAS (mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes) is uncertain.
We studied a 24-year-old man with MELAS who had fluent aphasia and right hemianopia. Magnetic resonance imaging and computed tomography showed a large infarction in the parietal, temporal, and occipital lobes. We performed serial planar 133Xe regional cerebral blood flow studies and single-photon emission computed tomography. Fifteen and 26 days after the stroke-like episode, there was generalized hyperperfusion, highest in infarcted areas. Four and 8 months after the stroke-like episode, the brain was still hyperemic, with highest flow in noninfarcted tissue. Reactivity to CO2 was less than normal within the infarct at 26 days but improved thereafter. In the noninfarcted region, vasomotor reactivity was impared at 4 months, when resting flows were at their peak.
We observed generalized cerebral hyperemia and fluctuating CO2 reactivity in MELAS, possibly a consequence of local lactic acid production. In addition, this case suggests that nonquantitative functional imaging may be misleading in MELAS.
Monocytes and Basophilic Granulocytes in the Cranial Circulation of Patients With Organic Brain Disorders
Authors: Thonnard-Neumann Ernst , Thonnard Costanza 
Published: June 2011

In 30 patients with organic brain disorders, blood samples from both ear lobes were examined for their white cell contents. In nine of them, blood from the external and internal jugular veins also was examined. The total white cell, neutrophil, and eosinophil counts did not show any difference when the two sides of the head were compared; nor was there any difference in the average-of-sides values of these cells in cranial blood samples when compared with blood from a finger puncture, or when compared with ear lobe blood from ten healthy control subjects.
Basophil values were lower in blood from the internal jugular veins than in blood from the external jugular veins, and basophils in ear lobe blood were at an intermediate level.
In patients with one-sided cerebral lesions, fewer basophils were found on the focal side even when the lesions were remote in time. Monocyte levels were higher on the focal side during the first two months after a cerebrovascular attack.
Patients with bilateral brain lesions had fewer basophils in ear lobe samples than normal controls but showed no side-related difference.
A single intravenous injection of 5,000 units of heparin caused an existing bias in basophil and monocyte values between focal and opposite side to disappear and produced an increase in the cranial level of these cells. The side-related differences did not reappear for an average of three weeks.
The findings with regard to the role of monocytes as precursors of cerebral macrophages and of basophils as carriers of heparin are discussed, and the examination of ear lobe blood is proposed as a noninvasive and simple method for hematological studies of cerebral disorders.
Cerebral Hemispheric "Counter-Steal" Phenomenon During Hyperventilation in Cerebrovascular Diseases
Authors: PISTOLESE G. RAIMONDO , FARAGLIA VITTORIO , AGNOLI ALESSANDRO , PRENCIPE MASSIMILIANO , PASTORE ENRICA , SPARTERA CARLO , FIORANI PAOLO 
Published: June 2011

Use of hyperventilation (HV) was recently suggested for the treatment of acute cerebrovascular insufficiency. There is indeed no general agreement on the effectiveness of hyperventilation even though clinical and experimental findings could support its value in clinical use.
During carotid surgery, hyperventilation was used in order to attenuate cerebral ischemia effects during carotid clamping, and a counter-steal phenomenon affecting a whole cerebral hemisphere was demonstrated.
This suggests the role that hyperventilation may play in the treatment of cerebral ischemia.
Arteriographically Visualized Extravasation in Hypertensive Intracerebral Hemorrhage
Authors: MIZUKAMI MASAHIRO , Araki Goro , Mihara Hiroshi , TOMITA TAKASHI , Fujinaga Ryozo 
Published: June 2011

Seven cases are reported in which extravasation of contrast medium from the lateral lenticulostriate artery was observed on cerebral angiography performed in the early stage of hypertensive intracerebral hemorrhage.
We advance the theory that continuous bleeding from the ruptured artery with mechanical destruction and displacement of cerebral tissue is the cause of massive hematoma formation, and discuss the possibility of surgical treatment of the acute stage of hypertensive intracerebral hemorrhage.
Arterial Peaks in Regional Cerebral Blood Flow
133
Xenon Clearance Curves
Authors: ROSENBAUM STEPHEN G. , ILIFF LINNETTE D. , BULL J. W. D. , DU BOULAY G. H. , MARSHALL JOHN , RUSSELL R. W. ROSS , SYMON LINDSAY 
Published: June 2011

In patients with normal rCBF, arterial spikes are found in all regions of the cerebral hemisphere. The normal range of spike height is 17% to 31 % of H max, except over the carotid siphon (region 15), when it is 36% to 38%.
Under general anesthesia proportionate spike height increases significantly when CBF is low. Increased blood flow is not, however, significantly associated with decrease in spike height.
The possible explanations for this are discussed.
Effect of pH on Metabolism and Ultrastructure of Guinea Pig Cerebral Cortex Slices
Authors: PATEL KUSUM K. , HARTMANN J. FRANCIS , COHEN MAYNARD M. 
Published: June 2011

Lactic acidosis is a prominent biochemical alteration which follows cerebral ischemia and is of sufficient degree to result in pH decrease in involved and adjacent tissue. Because of the significance of acidosis in the cerebral ischemic process, we have investigated ultrastruclural changes and some biochemical parameters under varying pH conditions using guinea pig cerebral cortex slices.
Metabolic rates decreased markedly during acidic incubations, and increased only minimally during basic incubations. Acidic pH affected oxygen and glucose utilization rates and fine structure to a greater degree than did an equal change in pH from 7.4 toward the alkaline. Glucose consumption was affected by pH deviations from 7.4 to a greater degree than oxygen uptake.
VIII. Training, Education, Manpower, and Research for Stroke Care
Authors: GIFFORD RAY W. , BELL RODERIC M. , GILROY JOHN , GOLDSCHMIDT JOHN W. , GREENHOUSE ARNOLD H. , LEONE LUCILE P. , MCHENRY LAWRENCE C. , O'LEARY JAMES L. , POWERS LELAND E. , SCHATZ IRWIN J. , SCHWARTZ HENRY G. , STEARNS NORMAN S. 
Published: June 2011

The manpower required for diagnosis and management of the 500,000 patients who experience stroke in the United States annually encompasses numerous disciplines, beginning with the family physician. The medical specialists and allied health personnel chiefly involved in addition are the neurologist, internist/cardiologist, nurse, physiatrist, physical therapist, occupational therapist, and speech therapist. Besides these, services of the radiologist, neurosurgeon, vascular surgeon, psychiatrist, orthopaedist, urologist, ophthalmologist, and pathologist frequently are needed. Important support is given by the dietitian, social worker, psychologist, and vocational rehabilitation counselor. Statistics are included for manpower available at present in a number of these disciplines.
Training and education extend throughout all levels, from the undergraduate through the postgraduate, and including continuing education. The knowledge and skills which each of these special groups should possess for competence in the area of stroke are described. The results of a survey are summarized, indicating the current status of stroke care in the curricula of United States medical schools and schools of osteopathy.
The concept of a stroke team is presented, describing the advantages of interdisciplinary action and effective utilization of available personnel and resources for patient care and for educational and training functions. An example is cited to demonstrate its feasibility and to illustrate the methods of establishing a local stroke program.
The list of research needs in the area of stroke is extensive--over 100 pertinent topics are cited. Recommendations of the study group are summarized.
Dexamethasone as Treatment in Cerebrovascular Disease. 2. A Controlled Study in Acute Cerebral Infarction
Authors: BAUER RAYMOND B. , TELLEZ HENRY 
Published: June 2011

Fifty-four patients with acute cerebral infarction were included in a double-blind study to evaluate Decadron® as therapy. When comparison of patients with similar levels of consciousness was made, there was no significant difference between those patients receiving Decadron® and those receiving placebo therapy.
Three patients developed gastrointestinal tract bleeding in the placebo group, but there were none in the Decadron®-treated group.
There was no good correlation between the clinical state of the patient and the CSF pressure, either on admission or during the 14-day course of the study.
Physiological Responses of Local Areas of the Cerebral Circulation in Experimental Primates Determined by the Method of Hydrogen Clearance
Authors: SYMON LINDSAY , PASZTOR EMIL , DORSCH N. W. C. , BRANSTON NEIL M. 
Published: June 2011

The reactivity of cortex, putamen and white matter to changes in arterial CO
2
tension has been assessed. There was no significant difference between the CO
2
reactivity obtained for the three tissues which were in the region of 2% to 3.5% increase over basal blood flow per mm Hg P

CO

CO
2

increase. The data suggested a somewhat greater reactivity for white matter than for gray matter, though differences were not significant.

Excellent autoregulation to altered perfusion pressure, induced either by hemorrhage or by raising the intracranial pressure with cisternal infusion, was found in gray matter of cortex and putamen and in white matter. With reduction of perfusion pressure by both techniques, it appeared that zero blood flow could be more readily induced in white matter than in gray matter.
Autoregulatory curves to change in perfusion pressure obtained by either method seemed identical, suggesting that the mechanisms involved in the maintenance of cerebral blood flow in the face of reduced arterial pressure or rising intracranial pressure are the same.
Hyperemia was observed in all three areas of the cerebral circulation examined following the restoration of perfusion pressure after a period of reduction. No significant differences in the degree of hyperemia induced by similar stimuli were observed in these three sites.
Cardiovascular Dimensions in Patients With Intracranial Arteriovenous Malformation
Authors: PERÄSALO JUHANI , WALTIMO OLLI , RICHTER TIMO HEISKANEN 
Published: June 2011

The hemodynamics of 29 adult subjects with a congenital intracranial arteriovenous malformation were studied by radiocardiography. The cardiac index, heart rate, stroke index, systemic arterial pulse pressure and radiographical heart volume did not differ significantly from the normal. However, the total blood volume (P < 0.001) and the plasma volume (P < 0.05) were greater than normal.
The radiocardiograms of 17 patients were analyzed by analogue computer. The right heart blood volume (P < 0.05) and the left heart blood volume (P < 0.02) were above normal, but of equal magnitude. The pulmonary blood volume did not differ from the normal. The same was true of the respective volumes as percentages of the total blood volume. The cardiopulmonary (P < 0.01) and the peripheral (P < 0.005) blood volumes were greater than normal.
The results indicate that the major circulatory consequence of a congenital intracranial arteriovenous malformation is an increased circulating blood volume.
The size or the location of the malformation did not correlate with the hemodynamic parameters.
Failures and Successes in a Stroke Program
Authors: DOW ROBERT S. , DICK H. LENOX , CROWELL FRED A. 
Published: June 2011

The activities toward stroke prevention and improving stroke care at Good Samaritan Hospital and Medical Center of Portland, Oregon, for the past ten years are described. The program was multifaceted and included a stroke clinic, a stroke care unit, a course for nurses from throughout the state of Oregon and southwestern Washington, panel discussions and exhibits about stroke care, an educational program for families of stroke patients and satellite clinics at two small communities in Oregon.
The presence of this program changed the percentage of patients with strokes of equal severity going home from 13% to 58% at Good Samaritan Hospital and Medical Center and no similar trend could be detected in five other hospitals in Portland during a comparable period.
The evaluation of the program revealed that a team approach to stroke care in a special unit improved the care of stroke patients throughout the hospital and was effective in bringing the family into an active role in rehabilitation and patient care. The program also achieved educational goals.
Epidemiology of Stroke: Emphasis on Transient Cerebral Ischemic Attacks and Hypertension
Authors: WHISNANT JACK P. 
Published: June 2011

The three factors other than age that are the most important determinants of stroke occurrence are (1) transient cerebral ischemic attacks (TIAs), (2) hypertension, and (3) cardiac disease.
In the Rochester population study, a stroke developed during the period of observation in 36% of the patients with TIAs. Fifty-one percent of all the strokes occurred during the first year after the TIA, and 21% occurred during the first month after the first attack.
Hypertensive persons have an increased incidence of each of the major atherothrombotic diseases as compared to normotensive persons.
During the full 25 years of study of the Rochester population, there was a decrease from the earliest to the latest five-year period of 32% for all strokes in women and 20% in men. This may reflect treatment of this population.
Cerebral Metabolic Changes During Treatment of Subacute Cerebral Infarction by Alpha and Beta Adrenergic Blockade With Phenoxybenzamine and Propranolol
Authors: STIRLING JOHN , OKAMOTO SHIGEMICHI , SHIMAZU KUNIO , KOTO ATSUO , OHUCHI TADAO , SARI ATSUO , ERICSSON ARTHUR DALE 
Published: June 2011

Cerebral hemispheric blood flow (HBF) and metabolism were measured in 30 patients with acute and subacute cerebral infarction before and after intracarotid infusion of the alpha adrenergic blocking agent phenoxybenzamine (PBZ) or the beta adrenergic blocker propranolol (PPL) dissolved in saline. Following intracarotid injection of 7 µg per kilogram per minute PBZ, HBF showed no change but cerebral hemispheric oxygen consumption (HMIO
2
) and carbon dioxide production (HMICO
2
) decreased. Glucose consumption (HMIGl) was unchanged but the glucose to oxygen utilization ratio (HG:O) increased. Intracarotid injection of 1.45 µg per kilogram per minute PPL caused reduction of HBF, HMIO
2
, HMICO
2
, HMIGl and HG:O. After PBZ infusion, mean systemic arterial blood pressure (MABP) decreased slightly, intracranial venous pressure (ICVP) and CSF pressure (CSFP) increased, and central venous pressure (CVP) remained unchanged. PPL infusion had no effect on intracranial dynamics.

Possible mechanisms whereby PBZ and PPL influence cerebral metabolism and function were discussed. Inhibition of uncoupling of oxidative phosphorylation appeared to be the most likely explanation for the improvement in brain function and metabolic change associated with each of the drugs. These data support the concept that catecholamines released into brain tissue are a possible cause of uncoupled oxidative phosphorylation.
Presently available evidence suggests that adrenergic blocking agents warrant clinical evaluation in the treatment of acute cerebral ischemia, infarction, hemorrhage, and anoxia.
Pathogenesis and Natural History of Transient Global Amnesia
Authors: MATHEW NINAN T. , MEYIR JOHN STIRLING 
Published: June 2011

Fourteen patients aged between 49 and 92 years who had suffered from one or more attacks of transient global amnesia (TGA) have been followed for a mean interval of 30 months. Thirteen patients had one or more risk factors for cerebrovascular disease, such as hypertension, cardiac abnormalities, diabetes and hyperlipidemia. Clinical evidence for vertebrobasilar arterial insufficiency was demonstrated in 11 cases. EEG examination revealed bitemporal or bioccipital slow wave activity. Four-vessel arteriography showed atherosclerotic, stenotic, or occlusive lesions predominantly in the vertebrobasilar and posterior cerebral arterial systems. Five patients without recurrence of TGA showed no permanent impairment of memory, whereas eight who had recurrent attacks of TGA showed permanent memory impairment as well as mild visual-spatial or visual-motor dyspraxia as judged by neuropsychological tests on follow-up visits. "Amnesic stroke" with permanent and gross memory defect and dyspraxia occurred in two patients.
It is concluded that the majority of transient global amnesic episodes in the elderly or in those with the risk factors listed above result from cerebrovascular insufficiency particularly in the territory of vertebrobasilar and posterior cerebral arterial systems (which supply major portions of the ascending reticular activating system, parahippocampal-fornical-mamillary system, inferomedial aspects of the temporal lobe and occipital lobe). Repeated attacks of TGA are not rare and with each attack the likelihood increases of permanent memory deficits and progressive dementia. A rarer outcome is cerebral infarction in the territory of posterior cerebral arteries commonly referred to as "amnesic stroke."
Incidence and Early Prognosis of Stroke in Espoo-Kauniainen Area, Finland, in 1972
Authors: AHO KARI , FOGELHOLM RAINER 
Published: June 2011

A stroke register has been operating in the Espoo-Kauniainen area, Finland, since January 1, 1972. The study population was 108,000 persons on January 1, 1972. In order to find totally new cases of stroke the following sources were utilized: hospitals and practicing physicians serving the study area were contacted regularly, death certificates were perused every two weeks, and copies of medical certificates or stroke patients applying for sick leave were received from The National Pensions Institute.
During 1972 a total of 153 new stroke cases were registered, giving an incidence of 142/100,000/year. The young age structure of the study population (5.2% were 65 years or older) explains this relatively low incidence. When applied to the total population of Finland and adjusted for age and sex the incidence is 231/100,000/year. The total cases were distributed equally between men and women. Men in age groups 50 to 59 and 60 to 69 years had an incidence twice that of women. The opposite was true in the age group 70 to 79 years. The incidence increased steeply with age.
Case fatality during the acute phase, the first three weeks, was 38% for all stroke cases. In the different clinical entities the case fatality was highest among intracerebral hemorrhages (66%) and lowest among ischemic cerebral infarction (27%).
The results of the first year of registry give an incidence of stroke for Finland which is relatively high compared with many earlier studies from other countries.