Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Jan 1995
Transcranial Doppler signals during cerebral angiography and cardiac catheterization.
Cerebral angiography is associated with a 0.45-4% risk of neurological complications and a less than 1% risk of permanent neurological deficit. Recently, air embolism has been implicated as a major cause of these complications. Cardiac catheterization is associated with a neurological complication rate of less than 1%; the predominant mechanism appears to be embolic. ⋯ No spontaneous emboli were seen. None of our 42 patients developed any type of neurological symptoms during or after the procedure. These high-intensity signatures do not represent air embolism exclusively; rather, they are likely a combination of turbulence in the bloodstream created during rapid injection, air emboli, and, perhaps, echogenicity of the contrast medium.
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Unilateral oval pupil has numerous causes, and several pathophysiologic mechanisms have been proposed. Prognosis is nearly universally poor. ⋯ Both patients recovered. The prognosis for comatose patients with unilateral oval pupil is not universally poor.
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J Stroke Cerebrovasc Dis · Jan 1995
Prognostic significance of ST-segment depression on continuous electrocardiography in patients with acute ischemic neurologic events.
Patients with a history of ischemic stroke or transient ischemic attack (TIA) are at significant risk of cardiac death. This study reports the prognostic significance of ST-segment depression and ventricular tachycardia on continuous electrocardiography in 48 consecutive patients hospitalized with an acute ischemic stroke or TIA. Thirty-one percent of patients had episodes of asymptomatic ST-segment depression and 6% had transient ventricular tachycardia on continuous electrocardiographic monitoring. ⋯ However, ventricular tachycardia was associated with a higher rate of cardiac death (33% vs. 2%, p < 0.01). Only 27% of patients subsequently found to have coronary artery disease had ST-segment depression by continuous electrocardiography. In contrast to patients with coronary artery disease, ST-segment depression on continuous electrocardiography is not associated with poorer outcome among patients with acute ischemic stroke or TIA.