Acta neurologica Scandinavica. Supplementum
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Acta Neurol. Scand., Suppl.c · Jan 1988
Tomographic cerebral blood flow measurements in patients with ischemic cerebrovascular disease and evaluation of the vasodilatory capacity by the acetazolamide test.
Cerebral blood flow (CBF) was measured in a series of patients with ischemic cerebrovascular disease using xenon-133 inhalation and single photon emission computer tomography. The spontaneous course of CBF changes in a consecutive series of stroke patients was evaluated. A quite heterogeneous pattern of flow changes was observed: In patients with large cortical/subcortical infarcts, extensive hypoperfused areas were observed, often significantly larger than the corresponding hypodense lesion on the CT scan. ⋯ In order to differentiate between permanent flow changes caused by a functional impairment and a possible hemodynamic component, CBF was measured before and after administration of a potent cerebral vasodilator, acetazolamide (Diamox). In normal cases tested with Diamox, an even CBF increase is noted throughout the hemispheres, while the cerebral metabolic rate for oxygen remains stable. In patients having a severe stenosis or occlusion of the internal carotid artery, this vasodilatory stress test will identify the patients having poor collateral capacity via the circle of Willis.(ABSTRACT TRUNCATED AT 400 WORDS)
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Acta Neurol. Scand., Suppl.c · Jan 1987
Intracranial pressure: cerebrospinal fluid dynamics and pressure-volume relations.
Continuous measurement of the intracranial pressure (ICP) is routine in todays evaluation of various intracranial diseases and increased ICP is a common therapeutical problem in neurosurgical patients. Still, very little is known about the patho-physiological and biomechanic events that lead to increased ICP. ICP is governed by 1) the resistance to absorption of cerebrospinal fluid (Rout), 2) the production rate of CSF (If) (taken together Rout and If are referred to as the "CSF dynamics"), and 3) the pressure in the Sagittal Sinus (Pss) in accordance with the equation: ICP = If X Rout + Pss. ⋯ The latter was measured by means of the PVI method and in some instances for reasons of comparison with the constant rate infusion technique and "controlled withdrawal". The main conclusions of the studies were: 1) For estimates of PVI the bolus injection technique was applicable. For Rout measurements the method was only safe at relatively low ICP levels.(ABSTRACT TRUNCATED AT 400 WORDS)
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The diagnosis of Parkinson's disease is purely a clinical diagnosis. The most common types of diagnostic error are a failure either to recognize the early, or unusual symptoms, or to differentiate other tremors and extrapyramidal syndromes from Parkinson's disease. ⋯ This has resulted from the reduction of the excess mortality by levodopa treatment. In the near future, there will be more older parkinsonian patients with a more prolonged duration of the disease.