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Biomedical subjects

L R Caplan

Publications and source records attributed to L R Caplan.

250 records · Page 14Linked to original sources
PubMedDate not supplied

Basilar artery narrowing and hyperparathyroidism: illustrative case.

A patient presenting with a pontine infarction caused by mid-basilar artery narrowing associated with hyperparathyroidism is described. The narrowing reversed with surgical removal of his parathyroid adenoma and normalization of his serum calcium. This patient's illness lends evidence to the role of calcium in cerebral vasoconstriction.

Adenoma↗
PubMedDate not supplied

Intracerebral hemorrhage following carotid endarterectomy: a hypertensive complication?

Two patients with transient ischemic attacks and subsequent minor cerebral infarction had repair of very tight carotid stenosis, 4 and 5 weeks respectively after their stroke. Each developed intracerebral hemorrhage when hypertension was uncontrolled during the post-operative period. Hypertension is a significant complication of carotid endarterectomy, and may be a prominent factor in the development of intracerebral hemorrhage post-carotid endarterectomy.

Arteriosclerosis↗
PubMedDate not supplied

Subdural hygroma of the spinal meninges: a case report.

A case of a subdural hygroma or chronic subdural hematoma of the thoracolumbar spinal meninges is described. This became symptomatic 9 years after trauma. Terminological ambiguity is discussed, along with the detailed clinical, radiological, and operative presentations of this rare condition.

Adolescent↗
PubMedDate not supplied

[Ischemia of the vertebrobasilar territory: mechanisms and practical considerations].

OBJECTIVE: We first review historic, anatomic, and epidemiological aspects involving the vertebrobasilar territory ischemia. We describe the development of ideas regarding the stroke mechanisms and treatment in the posterior circulation. Key authors and their contributions are also mentioned. DEVELOPMENT: Several new diagnostic and therapeutic strategies have emerged during the last few decades in cerebrovascular disease. The comprehension of the ischemic stroke in the posterior circulation is more difficult than carotid circulation. Thus, vertebrobasilar stroke represents a microcosm. Several mechanisms may explain the ischemic process (large artery disease, penetrating vessel disease, cardioembolism, unusual causes of stroke, and combined or undetermined causes). One of the most common is large artery atherosclerosis. Transient ischemic attacks, usually stereotyped, may be the clue for the earliest recognition. Correct diagnosis may improve the chance of effective therapy. Some practical considerations may help to identify the underlying cause of the stroke. CONCLUSIONS: The prognosis in patients with vertebrobasilar ischemia depends on: a) the mechanism of the stroke, b) site of the vessel occlusion, c) thrombus propagation, d) collateral circulation, e) hemodynamic (hypertension, cardiac output, etc.), and hemorreologic factors (viscosity, hypercoagulable state, etc.), f) neurologic status, g) time to treatment. The accurate the diagnosis of the mechanism, the better the prognosis.

Basilar Artery↗
PubMedDate not supplied

Modeling the diagnosis of stroke at two hospitals.

A comparison of five major categories of stroke in 651 patients revealed significant differences in the frequencies of diagnoses at the Beth Israel and Massachusetts General hospitals in Boston, Mass. (P less than 0.001 by chi-square test). To analyze these differences, we modeled the diagnostic process at each hospital with a Bayesian procedure and performed a crossover study in which each patient was rediagnosed by the model from the opposite hospital. The results indicate that the differences in the frequency of lacune and subarachnoid hemorrhage were associated with the patient population, whereas the differences in the frequency of embolism and atherothrombosis were associated with the diagnostic process. There was a marked difference in the use of arteriograms on the two stroke services, but no difference in morbidity or mortality. The modeling procedure described can be used to compare clinical processes when the allocation of patients is thought to be biased.

Bayes Theorem↗
PubMedDate not supplied

Ataxic-hemiparesis.

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Ataxia↗