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Biomedical subjects

L Thomassen

Publications and source records attributed to L Thomassen.

27 records · Page 2Linked to original sources
PubMed1999

[Thrombolytic therapy in acute cerebral infarction--a time study when organizing a new therapeutic option].

Cerebral thrombolysis is a therapeutic option for patients with acute cerebral infarction, but its use can be limited by delayed hospital admission. The aim of this study was to examine this delay, to improve admission routines and thus increase the number of potential candidates for treatment. In the first part of the study, time from first symptoms until hospital admission (time from first symptoms to contact with the primary health care system, and from contact to admission) was registered for 100 patients with acute stroke. Time spent to cerebral CT scan, and within the hospital was also registered. Measures to shorten admission time were then instituted, including information to the public and to primary health care professionals. An identical study was then performed on another 124 patients. Referral procedures were significantly improved, whereas time taken for patients to contact the primary health care system remained unchanged. Direct contact by emergency telephone secured the fastest admissions. The number of patients admitted within two hours after stroke onset increased from 17% to 26%. Four patients (3%) were treated with thrombolysis. Our study indicates that improved admission routines reduce admission delay. More public information is necessary to change patient behaviour.

Acute Disease↗
PubMed1999

[Dolichoectasia of the intracranial arteries and stroke].

Intracranial arterial dolichoectasia is a condition related to stroke. The prevalence in patients suffering from their first cerebral infarction is estimated to be 3%. Patients with dolichoectasia are more likely to have lacunar infarctions than those without. They have a higher survival rate and better functional prognosis after first cerebral infarction, but a higher rate of stroke recurrence. The aetiology and pathogenesis of the condition is unknown. Only 0.5% of patients suffering a first cerebral infarction have dolichoectasia of both the carotid and vertebrobasilar system. We describe a case of atypical dolichoectasia affecting both circulatory systems as well as the middle and anterior cerebral arteries, with intracerebral haemorrhage.

Cerebral Angiography↗
PubMed1995

[Stroke. An effective evaluation and specialized treatment].

Stroke is an acute disorder with a high fatality rate and with severe residual impairment among many of the survivors. Advances in neuroimaging and ultrasound have increased our understanding of the disease process. New drugs seem to reduce the neuronal damage caused by brain infarction if they are administered within the first few hours after onset of stroke. Management of stroke patients in a specialised stroke unit hastens recovery and is associated with a sustained reduction in mortality. Both recovery and survival can be jeopardized by cerebral, systemic, and cardiac complications, which may be attenuated by rigorous attention to general medical factors. Treatment of acute stroke will certainly change dramatically in coming years.

Cerebrovascular Disorders↗
PubMed1994

Subclavian steal phenomenon. Clinical and hemodynamic aspects.

Fifty-eight patients with subclavian artery stenosis were classified as having definite or probable vertebrobasilar symptoms, carotid symptoms or no symptoms. The vertebral artery flow pattern was graded as no subclavian steal (Grade 0), systolic deceleration (Grade 1), alternating flow (Grade 2), or reversed flow (Grade 3). We found a statistically significant association between the occurrence of vertebrobasilar symptoms and the subclavian steal phenomenon Grades 2-3. No significant association could be established between time course, type or severity of symptoms and grade of steal phenomenon. The flow disturbance is probably one causal factor for the occurrence of symptoms. Reversed vertebral artery flow is commonly asymptomatic, however, and other non-identified cofactors must be operative in symptomatic patients.

Adult↗
PubMed1990

[Mollaret's meningitis].

Mollarets meningitis is a rare form of recurrent aseptic meningitis where a diagnostic feature is the characteristic cytologic picture in the cerebrospinal fluid. The article presents two cases that were clinically diagnosed as Mollarets meningitis. The cytologic picture of the cerebrospinal fluid is described and the major clinical aspects and the differential diagnoses are discussed briefly.

Adult↗
PubMed1990

Bilateral non-traumatic carotid cavernous sinus fistula with spontaneous closure.

A case of bilateral spontaneous carotid cavernous sinus fistula is presented. The diagnostic value of Doppler ultrasound examination is discussed, as well as therapeutic measurements, such as manual compression of the carotid artery and embolization treatment. The frequent spontaneous closure of these fistulas is emphasized, and a conservative attitude is recommended.

Aged↗
PubMed1989

[Balloon dilatation of subclavian artery stenosis and brachiocephalic trunk stenosis].

We report our initial experiences concerning percutaneous transluminal angioplasty of four subclavian artery stenoses and one innominate artery stenosis in four patients. In two patients the indication for percutaneous transluminal angioplasty was a severe subclavian steal syndrome, in one patient prophylactic treatment together with carotid endarterectomy before coronary bypass surgery, and in one patient a brainstem infarction. Percutaneous transluminal angioplasty resulted in normal vertebral artery blood flow in all patients and in complete relief of symptoms in the two patients with a subclavian steal syndrome. We experienced no cerebrovascular complications and only one minor peripheral complication. During a follow-up period of seven to 18 months there has been no re-occlusion and no sign of increasing subclavian steal phenomenon. We draw the following conclusions: Selection criteria for percutaneous transluminal angioplasty must be very strict. Doppler sonography before percutaneous transluminal angioplasty is necessary to evaluate the haemodynamic effect of subclavian stenosis upon the vertebral arteries. Doppler sonographic monitoring during percutaneous transluminal angioplasty should be a routine. The risk of cerebral complications is low. Gradual normalisation of vertebral blood flow after percutaneous transluminal angioplasty is common. Percutaneous transluminal angioplasty is judged to be a safe and effective treatment for patients suffering from subclavian steal syndrome.

Angioplasty, Balloon↗
PubMed1989

Cerebral air embolism after transthoracic aspiration with a 0.6 mm (23 gauge) needle.

A 54 yr old man experienced weakness in his legs, ataxia and subsequent urinary retention after a percutaneous fine-needle aspiration of a tumor in the right lower lobe. Clinical neurological examination and electroencephalography revealed signs of a brain stem lesion, probably due to an air embolism to the basilar artery. The symptoms and signs gradually disappeared prior to, as well as after, hyperbaric oxygen treatment. We believe this to be the first case of air embolism after transthoracic puncture with a 23 gauge needle to be reported in medical literature.

Biopsy, Needle↗