An open, randomized, controlled study including 57 patients with acute cerebral infarct was performed. All the patients, followed and controlled by the same examiner, received, in the first ten days, 24 mg/die i.v. of dexamethasone. 28 patients were also treated with mesoglycan (150 mg/die i.m. for five days and 144 mg/die per os for a further twenty-five days). The differences between the basal and final scores in the mesoglycan group and in the controls were not statistically significant as analysed by the Mann-Whitney U test. The mesoglycan influenced only slightly the laboratory values (PT, PTT, alkaline phosphatase, GOT, GPT, cholesterol and triglycerides, fibrinogen, blood glucose, azotemia and creatinine) performed before the beginning of the treatment, as their changes after thirty days of therapy were in the normal range. The mesoglycan was very well tolerated and no side-effects were observed during the treatment.

Acute Disease↗

PubMedDate not supplied

[Concordance of carotid bruit and positivity of computerized digital angiography of the epiaortic vessels in carotid stenotico-occlusive pathology].

256 patients (187 men and 69 women, aged 60 on the average) with carotid artery bruits, underwent digital subtraction angiography of the epiaortic vessels. The carotid artery stenoses of more than 50% and the carotid artery occlusions have been considered angiographically and compared with the evidences of the auscultation over the carotid bifurcation. The sensibility, specificity and overall accuracy of the carotid bruits were estimated. The sensibility was of 95%, the specificity of 83% and the overall accuracy of 92% when a carotid artery stenosis of more than 50% was detected. When a carotid occlusion was found the sensibility was of 71%, the specificity of 84% and the overall accuracy of 80%. When both the carotid stenosis of more than 50% and the carotid occlusion have been considered together, the sensibility was of 92%, the specificity of 84% and the overall accuracy of 90%. The Authors suggest that the carotid bruits are trustworthy witnesses of occlusive carotid artery disease.

Arterial Occlusive Diseases↗

PubMedDate not supplied

[Migraine crisis and neurological focal signs of slow or absent resolution (complicated migraine)].

Sixteen cases of vascular headache of the migraine type are referred in whom marked neurological manifestations occurred in a unilateral distribution as part of a migraine attack ("complicated migraine"). The neurologic disorders observed, in order of frequency, include 10 cases of motor hemiparesis, 3 cases of unilateral cerebellar syndrome, 1 case of sensory-motor hemiparesis and 1 case showing signs of the involvement of the motor nuclei of the bulb. The recovery of the motor, sensory, cerebellar and brainstem defects was very slow (average duration: 44.25 days; mode: 14 days) in twelve cases. Two patients showed residual neurological signs respectively after 1 and 7 years from the migraine attack. The patients histories indicate classic or common migraine with a relatively high frequency (80% of the patients experienced one or more crises per month). The most of cases (75%) were female patients. The patients, at time of the attack of complicated migraine, had a mean age years of 32. In ten cases first-grade relatives suffered from classic or common migraine; in no case was there any report of associated or complicated migraine among the relatives. In 4 of the 16 cases the CT scan showed an area of hypodensity consistent to the region of the brain expected to be suffering in view of the clinical type of neurological defect. The Authors take into consideration the controversial relation between complicated migraine with slow or incomplete resolution of neurologic signs and focal brain ischemia due to atherothrombotic infarct, pointing out that the present state of knowledge prevents the reaching of final conclusions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMedDate not supplied

[The electroencephalogram and lacunar infarcts].

The authors compare the conventional EEG of 16 patients with lacunar infarct, 18 patients suffering from subcortical infarct and 59 patients suffering from cortico-subcortical infarct, all confirmed by CT scan. They remark that while among patients with single or multiple lacunar infarct, 62% of the EEG turned out to be normal and 31% showed unilateral abnormalities, among those suffering from subcortical and cortico-subcortical infarct the EEG was normal only in 14% and showed unilateral abnormalities or focal alterations in 74% of the patients (chi square = p less than 0.01). According to these results the authors discuss the EEG's value in the differential diagnosis of lacunar infarcts and the influence on prognosis and on the therapeutical and diagnostic approach of these patients.

Aged↗