Stroke; a journal of cerebral circulation
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Review Comparative Study
Neurosurgical clipping versus endovascular coiling of patients with ruptured intracranial aneurysms.
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Clinical Trial Controlled Clinical Trial
Diabetic patients have an impaired cerebral vasodilatory response to hypercapnia under propofol anesthesia.
The purpose of this study was to examine the effects of diabetes mellitus and its severity on the cerebral vasodilatory response to hypercapnia. ⋯ Insulin-dependent diabetic patients have an impaired vasodilatory response to hypercapnia compared with that of the control group, and the present findings suggest that their degree of impairment is related to the severity of diabetes mellitus.
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Clinical Trial
Assessment of cerebrovascular autoregulation in head-injured patients: a validation study.
Cerebrovascular autoregulation is frequently measured in head-injured patients. We attempted to validate 4 bedside methods used for assessment of autoregulation. ⋯ Despite some variability, SROR(TCD) and PRx may provide useful approximations of autoregulation in head-injured patients. At least with our methods, CMRo2 changes with the increase in CPP; hence, flow-metabolism coupling may affect the results of autoregulation testing.
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The slowdown of a steeply declining trend in cardiovascular mortality has been reported in Japan, but precise reasons for this trend are uncertain. ⋯ Our data suggest that the decline in stroke incidence is slowing down and that the incidence of coronary heart disease has been increasing in the elderly in recent years. Insufficient control of hypertension and the increase in metabolic disorders may contribute to these trends.
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The goal of this study was to document the long-term outcome of ischemic stroke patients in a population with predominant intracranial atherosclerosis and risk factors for a recurrent event. ⋯ Patients with intracranial atherosclerosis, especially coexisting extracranial carotid disease, are at higher risk of suffering death or further vascular event. Our findings provide important data for planning future randomized clinical trials for this high-risk group of stroke patients.