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Biomedical subjects

L Bozzao

Publications and source records attributed to L Bozzao.

At least 73 records · Page 4Linked to original sources
PubMed1989

Ischaemic supratentorial stroke: angiographic findings in patients examined in the very early phase.

Eighty patients were studied by angiography within 6 h of an ischaemic stroke. Angiography was carried out with digital equipment and was usually limited to the vascular territory responsible for the neurological deficits. In 12 of 19 patients with internal carotid occlusion, the contralateral side was also studied. The angiographic abnormalities were classified as extracranial, intracranial, and combined extra and intracranial. The data show a high incidence (66%) of occlusive pathology of intracranial arteries, either isolated or associated with a significant presence of a potential embolic source (85%), and a high incidence of carotid occlusions located at the cervical segment (8 of 19). These observations suggest that most strokes are occlusive in origin.

Aged↗
PubMed1989

Occlusion of the extracranial internal carotid artery in the acute stroke; angiographic findings within 6 hours.

We studied by angiography 80 patients within 6 hours from the onset of symptoms of supratentorial ischaemic stroke. Occlusion of the internal carotid artery in the extracranial segment was found in 19 patients, at the bifurcation in 11 and at the cervical level in 8. While in the chronic phase of stroke, internal carotid artery occlusion in the cervical segment is an uncommon angiographic finding, we found a high frequency of occlusion at this level (8 out of 19) in our patients. Cervical segment occlusion may be due to a dissecting aneurysm or to an intracranial carotid artery occlusion (embolic or atherothrombotic) with subsequent migration of the clot down to this level. A direct embolic occlusion may be postulated as well.

Aged↗
PubMed1989

Clinical and instrumental evaluation of patients with ischemic stroke within the first six hours.

The development of fibrinolytic agents such as streptokinase and recombinant tissue type plasminogen activator (r-TPA) and other modalities of treatment in acute ischemic stroke, has raised the need for a more precise knowledge of the pathophysiology of the acute phases of ischemic stroke as it pertains to prediction of clinical outcome. In a prospective analysis, 80 patients were studied within less than 6 h from the onset of symptoms by means of a detailed protocol including clinical evaluation, cerebral computed tomography, digital angiography and ultrasound transcranial Doppler sonography. Early angiography revealed a complete arterial occlusion in 76% of cases, the majority of which were intracranial (66%). Seventy percent of the occlusions that were retested were removed within 1 week. Potential embolic sources were found in more than 80% of cases. Patients with documented intracranial occlusion and scarce or absent collateral filling at early angiography, had the worst clinical outcome (P less than 0.05), based on mortality data and the Canadian Neurological Scale. The 30-day mortality rate was 25%. Survival was significantly better (P less than 0.01) in patients with a Canadian Neurological Score on entry of greater than or equal to 6.5 than in patients with a less than 6.5 value. Our data indicate that early pathophysiological studies augment the clinical information and should be taken into account in the design and analysis of therapeutic trials of acute ischemic stroke.

Adult↗
PubMed1989

Early collateral blood supply and late parenchymal brain damage in patients with middle cerebral artery occlusion.

We angiographically studied 80 patients within 6 hours after the onset of ischemic supratentorial infarction. From this group we selected 36 patients with middle cerebral artery occlusion who survived. In these 36 patients, we compared the presence of a collateral blood supply during the early phase with the extent of final parenchymal brain damage obtained by computed tomography 3 months after the event. The presence of a collateral circulation during the first few hours after the stroke reduced the size of the final parenchymal brain damage in patients with middle cerebral artery stem-trunk occlusion. The collateral blood supply was more efficient in patients who had no significant stenosing lesions of the extracranial internal carotid artery. Our data confirm that the lenticulostriate arteries are end arteries not supplied by collateral blood vessels and suggest that lesions formerly thought to be caused by hemodynamic mechanisms (watershed infarcts) or arteriolar lesions (lacunar infarcts) may be due to middle cerebral artery occlusions.

Aged↗
PubMed1989

Comparison of cerebral angiography and transcranial Doppler sonography in acute stroke.

We compared digital intra-arterial angiography and transcranial Doppler sonography in acute cerebral ischemia as part of a wider study on a continuous series of 48 patients with acute focal cerebral ischemia in the carotid territory, observed within 4 hours of the onset of symptoms. The most significant Doppler findings of the middle cerebral artery included no detection of the artery when occlusion of the carotid siphon or the middle cerebral artery at its origin was shown by angiography and reduced flow velocities and asymmetry (symptomatic less than asymptomatic) when the occlusion was located in the terminal tract of the middle cerebral artery mainstem or in numerous terminal branches. Higher flow velocities in the anterior cerebral artery or posterior cerebral artery, mostly in the symptomatic hemisphere, often accompanied middle cerebral artery pathology, probably indicating collateral compensatory pathways.

Acute Disease↗
PubMed1988

Complicated migraine: case report.

The occurrence of long lasting focal neurological deficit as a complication of migraine is well known. A high incidence of C.T. scan abnormalities have been seen in subjects affected by severe complicated migraine; in some cases such lesions had the aspect of cerebral infarction. In this report we will relate case of a 29 year old woman with complicated migraine and multifocal suffering within the area of the hind brain circulation. The hypodense area we found with C.T. in the left cerebellar hemisphere and the reversibility of this lesion could support the hypothesis of focal edema in our case.

Adult↗
PubMed1988

Quantitative assessment of blood-brain barrier permeability in multiple sclerosis using 68-Ga-EDTA and positron emission tomography.

Fifteen patients with definite multiple sclerosis were examined with high volume delayed (HVD) CT scan and positron emission tomography (PET) using 68-Ga-EDTA as a tracer. The passage of 68-Ga-EDTA across the blood-brain barrier (BBB) was measured by using multiple graphical analysis. This method permits the simultaneous calculation of a blood to brain influx constant Ki (ml/g-1 min-1) and of the plasma volume Vp (ml/g-1). Focal areas of abnormal CT enhancement and pathological accumulation of 68-Ga-EDTA were visualised in four patients who were all examined during a clinical exacerbation of the disease. The mean Ki value measured in these areas was 12.5, SD 3.4 indicating a moderate but significant increase of BBB permeability compared with the value found in normal tissue (3.2, SD 0.9). No parallel increase in Vp values was found in these pathological areas. Quantitative data obtained with PET seems to provide further insight into the study of BBB function in multiple sclerosis.

Adolescent↗
PubMed1988

Changing prognosis of primary intracerebral hemorrhage: results of a clinical and computed tomographic follow-up study of 104 patients.

One hundred four consecutive cases of primary intracerebral hemorrhage hospitalized at the time of stroke were followed until death or for 1 year. All were treated nonsurgically. The 30-day mortality rate was 30%. Good clinical outcome and complete resolution of the lesion on computed tomography were observed in 49 and 13% of patients, respectively. Age, state of consciousness, and size of the hemorrhage on computed tomography scan were reliable prognostic indicators. The long-term survival rate, 66%, was higher than that previously reported and should be considered in future trials evaluating medical and surgical treatment of intracerebral hemorrhage.

Adult↗
PubMed1987

High resolution real-time B-mode echotomography in the diagnosis of extracranial carotid lesions. Comparison with traditional angiography.

Sixty-three patients (115 carotid arteries) have been examined first by Dopplersonography, then by echotomography and finally by angiography using the Seldinger technique. The comparison between echotomography and angiography showed a sensitivity of 0.9, a specificity of 0.7 and a accuracy of 0.8. There have been 15 false positive results; in 14 of them the lesions were lower than 10% of lumen reduction and in one case there was a 10-45% stenosis. It seems that echotomography can better estimate lower degree lesions. It was difficult for echotomography to detect correctly the presence of an occlusion and to evaluate the surface aspect mainly in the presence of ulcerations.

Adult↗
PubMed1987

Sequential computed tomography and 123I-HIPDM scans in multiple sclerosis with large plaque. A case report.

We report a case of acute multiple sclerosis in whom computed tomography (CT) scan suggested the presence of a large plaque. The anatomical and functional recovery of the brain tissue was followed by means of repeated CT scan and 123I-HIPDM studies. Single photon emission CT may be successfully employed to monitor the pathophysiological changes associated with the demyelinating process.

Adult↗