Stroke; a journal of cerebral circulation
-
Comparative Study Clinical Trial
Cerebral autoregulation in carotid artery occlusive disease assessed from spontaneous blood pressure fluctuations by the correlation coefficient index.
Estimation of dynamic cerebral autoregulation from spontaneous fluctuations of arterial blood pressure (ABP) and cerebral blood flow velocity (CBFV) is an attractive monitoring option for cerebral hemodynamic impairment. We evaluated the correlation coefficient index method in patients with severe obstructive carotid disease and compared it with transfer function analysis (frequency domain approach to cerebral autoregulation) and CO2 vasomotor reactivity. ⋯ The potential of the correlation coefficient indexes Dx and Mx in detecting hemodynamic impairment in patients with carotid stenosis is comparable to that of transfer function analysis and CO2 reactivity testing. In future, a combination of various hemodynamic tests might help to identify patients at risk for ischemic events.
-
Case Reports
Histopathological evaluation of middle cerebral artery after percutaneous intracranial transluminal angioplasty.
Intracranial atherosclerosis accounts for 8% to 10% of all ischemic strokes, and intracranial angioplasty is increasingly performed to treat stenotic lesions. We report an autopsy case and discuss the effects of intracranial angioplasty for atherosclerotic arteries. ⋯ Histopathological findings after intracranial angioplasty parallel those in other arterial territories. The implications of these pathological findings on the medical and endovascular treatment of intracranial atherosclerosis are discussed.
-
The goal of this study was to examine the impact of hospital characteristics on outcome after the treatment of ruptured and unruptured cerebral aneurysms. ⋯ Hospital procedural volume and the propensity of a hospital to use endovascular therapy are both independently associated with better outcome. Improvement in outcome could be achieved by a program of regionalization and selective referral for the treatment of cerebral aneurysms.
-
Hyperglycemia has a deleterious effect on brain ischemia. However, the effect of hyperglycemia in intracerebral hemorrhage (ICH) is not well known. We investigated the effect of hyperglycemia on the development of brain edema and perihematomal cell death in ICH. ⋯ Hyperglycemia caused more profound brain edema and perihematomal cell death in experimental ICH.