Biomedical subjects
L Caplan
Publications and source records attributed to L Caplan.
Disease of the carotid system.
Tremendous progress has been made in the investigation of occlusive disease of the internal carotid artery. With the advent of technologic advances such as CT scanning and more highly skilled personnel for the safe performance of cerebral angiography, diagnostic capabilities have been heightened. Carotid endarterectomy and surgical shunts have expanded the surgical armamentarium. Medical treatments have also proliferated.
Chronic vascular dementia.
Vascular disease is responsible for only a minority of cases of chronic dementia. Vascular dementia can be an end stage of a variety of mechansisms. Correct identification of the cause of the vascular disease is the key to successful treatment.
The American Indian--the long road to eye care.
Explore the source record for details and available documents.
Headache rounds: a tale of two brothers.
Explore the source record for details and available documents.
Vasculitis with urticaria, hypocomplementemia, and multiple system involvement.
A patient with cutaneous necrotizing vasculitis had chronic urticaria associated with multiple system involvement including arthralgias, glomerulonephritis, myositis, pseudotumor cerebri, and adenopathy. Persistent hypocomplementemia is noted with classic pathway activation. The syndrome recognized in this patient and those few individuals reported previously seems to constitute a distinct category of collagen-vascular disease.
Optometry and the Public Health Service.
Explore the source record for details and available documents.
Severe headache after carotid endarterectomy.
Explore the source record for details and available documents.
Familial aneurysms and infundibular widening.
Explore the source record for details and available documents.
An investigation of some aspects of stuttering-like speech in adult dysphasic subjects.
Explore the source record for details and available documents.
Right transaxillary thoracic aortography in the diagnosis of dissecting aneurysm.
Explore the source record for details and available documents.
Thrombus in vertebrobasilar dolichoectatic artery treated with intravenous urokinase.
BACKGROUND: Vertebrobasilar dolichoectasia is often found in patients with posterior circulation ischemia. Brain ischemia is caused by abnormal flow in the dilated artery and obstruction of paramedian arteries or intraluminal thrombus with artery-to-artery embolism. We report a patient with vertebrobasilar dolichoectasia and luminal thrombus treated with intravenous urokinase who did well but died 2 months later of subarachnoid hemorrhage. CASE DESCRIPTION: A 60-year-old man developed right-hand clumsiness, dysarthria and ataxia. Computed tomography showed vertebrobasilar dolichoectasia and thrombus in the basilar artery. Symptoms quickly resolved on heparin but recurred on warfarin and again resolved on heparin. Two weeks later, while on warfarin and aspirin 325 mg, he developed hand numbness, oscillopsia and ataxia. Symptoms again resolved on heparin. Angiography showed severe dolichoectasia of the distal right vertebral artery and basilar artery. A large mural thrombus was detected in the ventral part of the distal basilar artery narrowing the lumen by 50%. He was treated with intravenous urokinase 4,400 units/kg as a bolus followed by 4,400 units/kg/h for 12 h. Repeat angiography showed almost complete recanalization and improved filling of basilar artery branches. He was maintained on warfarin and aspirin 81 mg and had no further ischemic episodes. He died 2 months later of rupture of the basilar artery and subarachnoid hemorrhage. CONCLUSION: Some patients with thrombosis of vertebrobasilar dolichoectactic arteries continue to have ischemic symptoms despite adequate anticoagulation. Intravenous thrombolysis may be effective in reducing the risk of stroke, but the risk/benefit ratio needs to be assessed in each patient.
Acute stroke therapy trials: an introduction to recurring design issues.
We discuss selected issues concerning the design of stroke treatment trials. Key issues include the type of stroke studied, the time interval from stroke onset to patient entry, and whether to include cardioembolic strokes and allow concomitant therapy.