Cerebrovascular diseases
-
Cerebrovascular diseases · Jan 2006
Review Case ReportsThe fetal variant of the circle of Willis and its influence on the cerebral collateral circulation.
In a fetal-type posterior circle of Willis (FTP) there is an embryonic derivation of the posterior cerebral artery (PCA) from the internal carotid artery (ICA). Besides the fact that a larger area is thus dependent on the ICA, leptomeningeal vessels cannot develop between the anterior and posterior circulation. The tentorium namely prevents cerebellar vessels from connecting to the PCA territory. ⋯ An overview of the literature is given. We propose to define a partial FTP, in which a small P1 segment between the basilar artery and the postcommunicating part of the PCA is present, and a full FTP, in which the P1 segment is absent. Whether a full FTP is a risk factor for stroke should be subject of further investigation.
-
Cerebrovascular diseases · Jan 2006
Randomized Controlled Trial Multicenter StudyCiticoline in intracerebral haemorrhage: a double-blind, randomized, placebo-controlled, multi-centre pilot study.
In experimental models citicoline has shown beneficial effects in intracerebral haemorrhage. Citicoline is a neuroprotectant drug with some beneficial effects in human ischaemic stroke and with an excellent safety profile. We decided to carry out a pilot study to test its safety and efficacy in human intracerebral haemorrhaging. ⋯ Citicoline seems to be a safe drug in human intracerebral haemorrhage with a positive trend regarding efficacy. These data should be confirmed in a larger trial.
-
Cerebrovascular diseases · Jan 2006
Case Reports Randomized Controlled Trial Comparative StudySafety and therapeutical benefit of hemicraniectomy combined with mild hypothermia in comparison with hemicraniectomy alone in patients with malignant ischemic stroke.
Both for hemicraniectomy and for hypothermia, several reports describe a beneficial effect in patients with malignant supratentorial cerebral ischemia. We compared the safety and the clinical outcome in patients with a malignant supratentorial infarction who were treated with hemicraniectomy alone (HA) or received a combination therapy with hemicraniectomy and hypothermia of 35 degrees C (HH), respectively. ⋯ The present study suggests that a combined therapy of mild hypothermia and hemicraniectomy in malignant brain infarction does not imply additional risks by side effects and improves functional outcome as compared with hemicraniectomy alone.
-
Cerebrovascular diseases · Jan 2006
Comparative StudyModified Rankin scale with expanded guidance scheme and interview questionnaire: interrater agreement and reproducibility of assessment.
The modified Rankin scale (mRS) is commonly employed as a measure of functional outcome after stroke. The purpose of this study was to investigate the reliability of the mRS using an expanded guidance scheme and a corresponding questionnaire on an unprecedentedly large scale. ⋯ The data obtained suggest that our guidance scheme and questionnaire are useful for ensuring the quality of assessments made with the mRS.
-
Cerebrovascular diseases · Jan 2006
Comparative StudyDirect costs of surgical clipping and endovascular coiling of unruptured intracranial aneurysms.
Unruptured intracranial aneurysms can be preventively treated by surgical clipping or endovascular coiling. We determined in detail the costs of these treatments. ⋯ For unruptured intracranial aneurysms, direct in-hospital costs of coiling are on average higher than those of clipping, mostly because of the more expensive coils.