Biomedical subjects
Publications and source records attributed to H Lechner.
Computer-tomography investigations in 300 patients with cerebrovascular diseases are reported. The possibilities of computer-tomography for localization and follow-up of ischaemic attacks, intracerebral haematoma and subarachnoidal haemorrhages are described. Details of clinical and diagnostic importance of follow-up studies are presented together with examples of current pathological data.
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Two groups of patients who had a stroke, prolonged reversible ischaemic neurological deficit or transient ischaemic attacks were compared; one group was treated with anticoagulants (phenprocoumon) and a matched control group was treated with other substances. Results showed a similar survival rate in both groups, but significantly fewer recurrences were seen in the surviving patients treated with anticoagulants.
248 patients with an ischaemic stroke were investigated with computer tomography. A hypodense lesion was observed in 18% of TIAs, 76% of PRINDS and 95% of completed stroke patients. In the patients with TIA the hypodense lesions were mainly single ones, whereas completed stroke patients also had a significantly higher proportion of more bilateral lesions. Atrophy was present in 44% of TIA patients, 68% of PRIND patients and 82% of completed stroke patients. Atrophy was generalised in 60% of the patients and homolateral in only 16%. Contrast medium enhancement in a hypodense area occurred only in patients with PRIND and completed stroke and never in TIA aptients. Multiple lesions and atrophy were significantly more common in patients with dementia. The time course showed oedema initially in 47% of patients which fell to 25% after the 1st week. Contrast medium enhancement was present initially in 42% of the patients, rose to 70% until the 3rd week and then fell continuously until the 6th week. The change from an indistinct to a distinct outline of a lesion coincided with this.
Regional cerebral blood volume (rCBV) was measured in 14 patients with normal CT scans. An EMI CT 1010 scanner was used in combination with a computer subtraction technique. The mean CBV in the cortex was 5.0 ml/100 ml of tissue and 2.2 in the white matter. Regional differences were not significant and no difference was found between the right and left hemispheres.
208 patients with epilepsy were investigated by computertomography (Emi Scanner CT 1010 and CT 5005). In 173 patients with generalised epilepsy 87 had a normal scan, 51 revealed a definitive diagnosis and 37 showed generalised atrophy. Of the 35 patients with partial seizures a definitive diagnosis was possible in 22; representing a higher proportion than the group with generalised seizures. A definitive diagnosis from the CT Scan was significantly more common in both patients with generalised and partial seizures when pathological neurological findings were also present. Symptomatic epilepsy was only significantly commoner in Dementia patients with generalised seizures. A significantly higher proportion of patients over 30 years old demonstrated a symptomatic epilepsy than those under 30 years of age.
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The influence of Tinofedrine (0.12--0.17 mg/kg. bodyweight) on fibrinogen and platelet aggregation has been investigated in 45 patients (mean age 65 years) with recent cerebral infarction. Depending on the duration of medication a significant decrease of the fibrinogen level as well as of enhanced platelet aggregation has been observed. It is concluded from the present results that the decrease of enhanced platelet aggregation may be mediated by the fall of fibrinogen.
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5 patients are described in which normal pressure hydrocephalus was diagnosed. The criteria on which the diagnosis was based were a cerebrospinal fluid perfusion test and an air study. Pathological verification was additionally obtained in 2 patients. The clinical picture in all patients was characterized by dementia. 4 patients were incontinent and 3 were paraspastic.
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In 75 patients with neurological symptoms due to RCI serum fibrinogen, whole blood viscosity and platelet aggregability have been determined before treatment was started. In addition, in 24 of the patients also HBF has been measured. In patients with RCI viscosity was significantly increased. Serum fibrinogen was higher at increased viscosity levels and when enhanced platelet aggregation was evident. At low shear rates increased blood viscosity correlated significantly with serum fibrinogen as well as with reduction of HBF.
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