Severity of stroke and aspirin.
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Biomedical subjects
Publications and source records attributed to M Prencipe.
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Consistent literature data on the cerebrovascular risk in migraineous patients are lacking. Available preliminary clinical data (Italian Cooperative Cross-Sectional Case-Control Study) suggest that migraine can hardly be considered a relevant pathogenetic associated risk factor of focal cerebral ischemia.
We studied platelet aggregates, by Wu and Hoak's technique, in 73 patients (49 F and 24 M), aged 14-61 (mean age 50.4 +/- 12.2) with migraine. Platelet aggregates were expressed as Platelet Aggregate Ratio (PAR). We consider as pathological PAR values lower than 86. Mean PAR value of migraine patients (78.3 +/- 8.68 SD) was significantly lower (p less than 0.001) than that of 90 control subjects (95.4 +/- 6.15 SD). Normal PAR values were found only in 27.4% of the migraine patients. The patients were divided according to the interval from the last attack: 17 patients were studied in the 1st week (PAR = 73.76 +/- 7.6 SD; 5.8% of the values in the normal range), 15 in the 2nd week (76.6 +/- 7.02 SD; 13.3% of the values in the normal range) and 41 between 15th and 30th day (80.78 +/- 8.78 SD; 29.6% of the patients in the normal range). The mean PAR value of the patients studied during the first week was significantly lower (p less than 0.01) than that of the patients studied between 15th and 30th day. No significant differences were found between the patients with classical, common and complicated migraine.
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The present study has been devoted to the analysis of 120 patients presenting with reversible focal cerebral ischemia without conventional signs of cardiopathy and/or relevant atherosclerotic disease. In 77% of the patients vascular risk factors, such as hypertension or hyperlipemia, were present. In 23% of the patients, no abnormal finding was discovered at clinical, hematochemical and cardiological examinations. In these patients a further cardiological evaluation was performed with echocardiography. Dynamic electrocardiography was performed in 52 patients. Echocardiography and dynamic electrocardiography revealed the occurrence of 6 cases of mitral valve prolapse (MVP), 2 cases of frequent premature ventricular beats, and 1 proximal atrial arrhythmia. All 6 cases of MVP were detected in the subgroups of patients without vascular risk factors. In our patients younger than 45 years, the relative frequency of MVP attains 21.5%. This study confirms that MVP has to be regarded as a risk factor for focal cerebral ischemia in young patients.
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A longitudinal electroencephalographic study of 100 patients suffering from acute leukaemia is reported. An high incidence of EEG abnormalities indicates the central nervous system involvement with no clinical manifestations. The patients have been divided in two groups: A) with normal EEG and B) with pathological (cerebro-meningeal localisation) but many causes (metabolic, toxic or microcirculatory disturbances) can produce the abnormalities. Moreover therapy may cause CNS disturbances with EEG evidence. The most damaging seems to be the simultaneous association of radiation therapy and methotrexate.
Platelet hyperaggregability was tested in 62 TIA patients by means of the formalin fixing principle of Wu and Hoak. Compared to age-matched controls, the platelet aggregates ratio (PAR) was reduced from 0.99 +/- 0.04 SD to 0.807 +/- 0.14 SD. This means a highly significant increase of circulating platelet aggregates (CPA) in untreated TIA patients, regardless of the interval sinche the last attack (from 2 days to 1 year). PAR was especially reduced in patients with abnormal angiography (expressing pronounced cerebral or diffuse ATS) and it was possibly affected by previous antiplatelet treatment with ASA.
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