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Biomedical subjects

A Arboix

Publications and source records attributed to A Arboix.

At least 73 records · Page 4Linked to original sources
PubMed1996

[Clinico-anatomopathologic analysis of 25 patients with lacunar infarction].

BACKGROUND: Lacunar infarctions (LI) are associated with an excellent functional prognosis and mortality is exceptional during hospital stay. Therefore, clinico-pathological studies on LI are scarce. METHODS: A retrospective analysis was made of 50 consecutive necropsies of patients with cerebrovascular disease (CVD) from the brain archive of the Pathology Department performed from 1976 and 1985. A macroscopic and microscopic study was carried out of visualized LI which were classified in old or cystic, recent and through perivascular dilation. A clinico-pathologic evaluation was made by analyzing cerebrovascular risk factors, the associated neurological syndromes and mortality causes. RESULTS: Fifty percent of brains with CVD analyzed (25 out of 50) had LI. The total of LI was 107, with a mean of 4.2 +/- 3.4 LI per brain. The main location was at the basal ganglia (54.7%), mainly the putamen (35.8%). The most common lesional diameters ranged from 1 to 4 mm (68.5%). Arterial hypertension was the main cerebrovascular risk factor (84%). Fifty-two percent of brains with LI (n = 13) were asymptomatic (clinically silent LI) Twenty-four percent had a clinical course consistent with a pseudobulbar syndrome (n = 6). Twenty percent had a pure motor hemiparesis (n = 5) and the remaining 4% had a transient ischemic attack associated with the LI topography (n = 1). Mortality causes in LI were non-neurological in nature in 88% (n = 22), whereas in non-lacunar CVD they were neurological in nature in 60% (n = 15) (p < 0,0007). CONCLUSIONS: LI are usually multiple, with a small lesional diameter (from 1 to 4 mm) and clinically silent. Arterial hypertension was associated with 84% of cases and mortality causes are usually non-neurological in nature (88%).

Aged↗
PubMed1995

Ischemic stroke as first manifestation of essential thrombocythemia. Report of six cases.

BACKGROUND: Ischemic stroke as a presenting sign of essential thrombocythemia has been infrequently reported. We describe six patients in whom cerebrovascular disease was the first manifestation of this myeloproliferative disease. A positive endogenous megakaryocyte and/or erythroid colony growth from blood was a diagnostic criterion of essential thrombocythemia in patients with platelets counts lower than 600 x 10(9)/L. CASE DESCRIPTIONS: These six patients represented 0.54% of all patients with first stroke, 42.8% of all hematologic disorders associated with stroke, and 12.5% of all patients with essential thrombocythemia diagnosed from 1986 to 1992 at our institution. Eleven acute cerebrovascular accidents (6 transient ischemic attacks, 5 definitive cerebral infarcts) were registered. Mean time from ischemic stroke to diagnosis of essential thrombocythemia was 4.5 months (range, 1 to 12 months). The mean platelet count was 597 x 10(9)/L (range, 414 to 760 x 10(9)/L). Four patients had platelets counts lower than 600 x 10(9)/L. All patients had circulating erythroid progenitors, megakaryocytic progenitors, or both. CONCLUSIONS: Ischemic stroke as a presenting manifestation of essential thrombocythemia is probably underrecognized. The diagnosis of thrombocythemia should not be excluded on the basis of platelet counts lower than 600 x 10(9)/L. The availability of in vitro culture of hematopoietic progenitors from peripheral blood makes it possible to diagnose early and atypical cases.

Adult↗
PubMed1994

[Mortality in the acute phase of cerebrovascular disease: the registry of La Alianza-Hospital Central of Barcelona].

BACKGROUND: Few studies have been performed on mortality from acute cerebrovascular disease (ACVD) during hospital admission, particularly in Spain. METHODS: A prospective clinical analysis was performed in 1,356 consecutive patients with ACVD included in the Registry of Cerebrovascular Disease of the Central La Alianza-Hospital in Barcelona (1986-1992) with the aim of analyzing the causes of mortality during the acute phase of the disease and the time of hospital survival. RESULTS: The mortality of the series was 16% (13% from cerebral infarction and 29% from cerebral hemorrhage; p < 0.0001). The causes of mortality were not neurologic in 49%, neurologic in 42% and of unknown cause in 9%. The principal causes of death were: transtentorial herniation/compression of the cerebral trunk (TH/CCT) 34%, pneumonia 14%, sepsis 14% and heart disease 11%. TH/CCT was more frequent on hemorrhage than on cerebral infarction (50% vs 27%; p < 0.001) while heart diseases were more frequent in cerebral infarction (14% vs 3%, p < 0.03). TH/CCT was the most common cause of death during the first seven days, with the pneumonia-sepsis-pulmonary thromboembolism being the most common after the third week. On the other hand, heart disease and sudden death showed homogeneous presentation with regard to frequency. CONCLUSIONS: The causes of death during the acute phase of acute cerebrovascular disease are principally non neurologic (49%) being potentially preventable with the most frequent causes of death being from pneumonia, sepsis and pulmonary thromboembolism. Mortality of these patients may be decreased on correct diagnosis and treatment.

Acute Disease↗
PubMed1994

Headache in acute cerebrovascular disease: a prospective clinical study in 240 patients.

To evaluate the clinical features of headache in stroke, a prospective study was carried out in 240 consecutive patients with acute stroke who had intact expressive function. Headache occurred in 38%: 32% of 195 patients with ischemic stroke and 64.5% of 45 patients with hemorrhagic stroke (p < 0.0001). Headache patients were younger (mean age 62 +/- 15 vs 67 +/- 11.5 years) than non-headache patients (p < 0.01). A history of previous vascular or tension-type headache was found in 40.5% of the headache group, but in only 23.5% of the non-headache group (p < 0.01). In ischemic stroke, headache was observed in 41% of thrombotic infarcts, in 39% of cardioembolic infarcts, in 23% of lacunar infarcts and in 26% of TIA. Headache was significantly more common in thrombotic than lacunar infarcts (p < 0.05). In hemorrhagic stroke, headache was observed in all subarachnoid hemorrhages and in 58% of intraparenchymal hemorrhages. In ischemic stroke, the mean duration of the headache was 25 +/- 28 h and in hemorrhagic stroke 64.5 +/- 36.5 h (p < 0.00001). In ischemic stroke the headache was focal in 74% and mild or moderate in intensity in 74%. In hemorrhagic stroke, it was diffuse in 52% and the pain intensity was incapacitating in 70%. Headache was more common in vertebrobasilar stroke (59%), in comparison with carotid stroke (26%) or stroke of unclear vascular topography (33%) (p < 0.00001). Fifty-six and a half percent of patients with cortical stroke had headaches, as opposed to only 26.5% of patients with subcortical stroke (p < 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1993

[An analysis of 1000 consecutive patients with acute cerebrovascular disease. The registry of cerebrovascular disease of La Alianza-Hospital Central of Barcelona].

BACKGROUND: Registries of cerebral vascular disease (CVD) are useful in the study of the natural history of acute cerebrovascular disease (ACBD). Nonetheless there are few series which analyze the different stroke subtypes (SS) of CVD. METHODS: A descriptive and comparative clinical analysis was performed of the different SS of CVD from the registry of CVD of the La Alianza-Central Hospital of Barcelona (Spain). A prospective study of 1,000 consecutive patients with ACVD admitted in the Neurology Department from 1986-1991 was carried out. The registry recommended by the Study Group of Cerebrovascular Diseases of the Sociedad Española de Neurología (SEN) were used and the stroke subtypes classified in agreement with the Glossary of Neurology of the SEN. RESULTS: The mean age of the series was of 71 +/- 13 years with 537 patients being males. The frequency of the stroke subtypes in focal cerebral ischemia (FCI) was: thrombotic infarction 26%, lacunar infarction 16.9%, essential infarction 14.8%, cardioembolic infarction 12.4%, transient ischemic attacks 9% and infarction of unusual cause 3.5%. The frequency of the SS in cerebral hemorrhage (CH) was: intraparenchymatous hemorrhage 14.1%, subarachnoid hemorrhage 2.0%, subdural hematoma 1.2% and epidural hematoma 0.1%. Mortality of the series was 16.7% predominating in CH (28%) versus FCI (14%) (p < 0.00001). This was found to be greatest in cases of intraparenchymatous hemorrhage (31%) and in the cardioembolic infarction (28%) and lowest in the lacunar infarctions (0.6%). CONCLUSIONS: The most common stroke subtypes were those of thrombotic infarctions, lacunar infarctions and intraparenchymal hemorrhages. Essential infarctions constitute 14.8% of acute cerebral vascular disease. The classification of cerebral vascular disease in its different subtypes is recommendable since this has prognostic and therapeutic implications.

Acute Disease↗
PubMed1993

[Headache in acute cerebrovascular ischemic disease: a prospective clinical study of 195 patients].

BACKGROUND: Headache is a little known aspect in the study of acute ischemic cerebrovascular disease (AICVD). METHODS: To contribute to the knowledge of the clinical characteristics of headache in the different nosologic entities of AICVD a prospective study was performed in 195 patients consecutively studied by CT scan and/or cerebral MRI. RESULTS: There was headache in 32% of the total and in 41% of the thrombotic infarctions, 39% of the cardioembolisms, 26% of the transient ischemic attacks (TIA) and 23% of the lacunar infarcts. The mean duration was 25 +/- 28 hours. Headache was focal in 74% of the cases and of slight or moderate intensity in 74%. Headache was significantly more common in thrombotic infarctions than in lacunar ones (p < 0.05). It was more frequent when the topography is vertebrobasilar (57.5%), in comparison with carotid (21%) or undetermined (17.5%) (p < 0.0001). Headache was more common when topography was cortical (56.5%) in comparison with subcortical (26.5%) (p < 0.005). Eight per cent of the patients presented sentinel headache: 22% of the cardioembolic infarctions, 7% of the lacunars, 6.5% of the TIA and 5.5% of the thrombotic. CONCLUSIONS: Headache in acute ischemic cerebrovascular disease is not uncommon predominating in thrombotic infarctions and cardioembolisms of cortical topography and of vertebrobasilar vascular territory.

Acute Disease↗