[Ticlopidine and pentoxifylline in acute cerebral infarct. Clinical study on 151 patients].
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Acute Disease↗
Biomedical subjects
M Zorzon
Publications and source records attributed to M Zorzon.
[Side-effects and changes of some physiological parameters after administration of a single 20 to 30 mg dose of prazepam. Double-blind study].
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Blood Pressure↗
[Side-effects and changes in systemic arterial pressure after administration of a single dose of lorazepam].
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Adult↗
[Mesoglycan in acute focal cerebral ischemia].
An open, randomized, controlled study including 57 patients with acute cerebral infarct was performed. All the patients, followed and controlled by the same examiner, received, in the first ten days, 24 mg/die i.v. of dexamethasone. 28 patients were also treated with mesoglycan (150 mg/die i.m. for five days and 144 mg/die per os for a further twenty-five days). The differences between the basal and final scores in the mesoglycan group and in the controls were not statistically significant as analysed by the Mann-Whitney U test. The mesoglycan influenced only slightly the laboratory values (PT, PTT, alkaline phosphatase, GOT, GPT, cholesterol and triglycerides, fibrinogen, blood glucose, azotemia and creatinine) performed before the beginning of the treatment, as their changes after thirty days of therapy were in the normal range. The mesoglycan was very well tolerated and no side-effects were observed during the treatment.
Acute Disease↗
[Atrial fibrillation and acute ischemic cerebrovascular disease. Study of 500 cases of cerebral infarction and transient cerebral ischemic attacks].
The prevalence of chronic atrial fibrillation (AF) and the clinical features in 151 patients with transient ischemic attacks (TIA) and in 349 patients with cerebral infarct have been analyzed. AF was found in 11.9% of patients with TIA and in 14.9% of patients with cerebral infarct. The difference was not significant (NS). In patients without AF, the carotid artery TIAs represent 70.6% of all TIAs, while the vertebral basilar artery TIAs account for 29.4%. When AF is present, 88.9% of all TIAs belong to the carotid artery and 11.1% to the vertebral basilar artery circulatory system (NS). TIAs lasting less than 10 minutes are 42.1% when AF is not present, while when AF is present they are only 11.1% (p less than 0.001). In patients without AF 79% of TIAs last less than one hour, while in patients with AF the percentage goes down to 38.9% (p less than 0.001). In patients with or without AF, the chronic digitalis therapy before the hospitalization does not affect in any way the occurrence of TIA or cerebral infarct. These results suggest that emboli from the atrium are more likely to cause cerebral infarcts than TIAs and when they cause TIAs more usually they last hours than minutes.
Atrial Fibrillation↗
[Concordance of carotid bruit and positivity of computerized digital angiography of the epiaortic vessels in carotid stenotico-occlusive pathology].
256 patients (187 men and 69 women, aged 60 on the average) with carotid artery bruits, underwent digital subtraction angiography of the epiaortic vessels. The carotid artery stenoses of more than 50% and the carotid artery occlusions have been considered angiographically and compared with the evidences of the auscultation over the carotid bifurcation. The sensibility, specificity and overall accuracy of the carotid bruits were estimated. The sensibility was of 95%, the specificity of 83% and the overall accuracy of 92% when a carotid artery stenosis of more than 50% was detected. When a carotid occlusion was found the sensibility was of 71%, the specificity of 84% and the overall accuracy of 80%. When both the carotid stenosis of more than 50% and the carotid occlusion have been considered together, the sensibility was of 92%, the specificity of 84% and the overall accuracy of 90%. The Authors suggest that the carotid bruits are trustworthy witnesses of occlusive carotid artery disease.
Arterial Occlusive Diseases↗
[Reliability of Doppler ultrasonography in relation to computerized digital angiography in patients with carotid bruit].
The results of the carotid artery Doppler ultrasound examination were compared with those of digital subtraction angiography in 256 patients (187 men and 69 women) with carotid bruit. The hemodynamically significant stenoses of more than 50% and the occlusions in the 512 carotid arteries examined were considered and the sensibility, the specificity and the overall accuracy of the Doppler ultrasound examination were calculated. When a carotid stenosis was diagnosed a sensibility of 97%, a specificity of 95% and an overall accuracy of 96% was found, while, for the diagnosis of carotid occlusion, the extimated sensibility, specificity and overall accuracy was 95%. Therefore, the ability to recognize a normal or an occluded carotid artery was of 95% (we found 125 out of 131 normal carotid arteries and 52 out of 55 occluded carotid arteries), whereas a stenotic carotid artery was identified in the 97% of cases (316 out of 326 stenotic carotid arteries). When both diagnoses of carotid stenosis and carotid occlusion were considered together, the extimated sensibility, specificity and overall accuracy were of 98%, 95% and 98% respectively. So the probability of misdiagnosing was of 2% (we made 10 wrong diagnoses out of 512 carotid arteries examined).
Arterial Occlusive Diseases↗
[Migraine crisis and neurological focal signs of slow or absent resolution (complicated migraine)].
Sixteen cases of vascular headache of the migraine type are referred in whom marked neurological manifestations occurred in a unilateral distribution as part of a migraine attack ("complicated migraine"). The neurologic disorders observed, in order of frequency, include 10 cases of motor hemiparesis, 3 cases of unilateral cerebellar syndrome, 1 case of sensory-motor hemiparesis and 1 case showing signs of the involvement of the motor nuclei of the bulb. The recovery of the motor, sensory, cerebellar and brainstem defects was very slow (average duration: 44.25 days; mode: 14 days) in twelve cases. Two patients showed residual neurological signs respectively after 1 and 7 years from the migraine attack. The patients histories indicate classic or common migraine with a relatively high frequency (80% of the patients experienced one or more crises per month). The most of cases (75%) were female patients. The patients, at time of the attack of complicated migraine, had a mean age years of 32. In ten cases first-grade relatives suffered from classic or common migraine; in no case was there any report of associated or complicated migraine among the relatives. In 4 of the 16 cases the CT scan showed an area of hypodensity consistent to the region of the brain expected to be suffering in view of the clinical type of neurological defect. The Authors take into consideration the controversial relation between complicated migraine with slow or incomplete resolution of neurologic signs and focal brain ischemia due to atherothrombotic infarct, pointing out that the present state of knowledge prevents the reaching of final conclusions.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
[The electroencephalogram and lacunar infarcts].
The authors compare the conventional EEG of 16 patients with lacunar infarct, 18 patients suffering from subcortical infarct and 59 patients suffering from cortico-subcortical infarct, all confirmed by CT scan. They remark that while among patients with single or multiple lacunar infarct, 62% of the EEG turned out to be normal and 31% showed unilateral abnormalities, among those suffering from subcortical and cortico-subcortical infarct the EEG was normal only in 14% and showed unilateral abnormalities or focal alterations in 74% of the patients (chi square = p less than 0.01). According to these results the authors discuss the EEG's value in the differential diagnosis of lacunar infarcts and the influence on prognosis and on the therapeutical and diagnostic approach of these patients.
Aged↗
[The hematocrit and atherothrombotic cerebral infarcts].
The authors compare the hematocrit values of 131 patients suffering from an acute cerebral atherothrombotic infarct, confirmed by CT scan, with those of 165 controls of the same age and sex. Both the analysis of the average by the Student's t test and the comparison between the distribution of frequencies by the chi square test, point out that hematocrit is significantly higher (p less than 0.001) in infarcts than in controls. Dividing patients according to CT scan (negative, lacunar infarct, cortical and/or subcortical infarct), no significant difference in hematocrit levels among the three groups is noticed. The authors confirm the positive association between hematocrit and atherothrombotic cerebral infarct and discuss the possible implications in the prevention and the therapy of cerebral ischemic stroke.
Blood Viscosity↗
[Smoking and acute cerebrovascular disorders of the ischemic type].
In order to define the relationships between cigarette smoking and occurrence of cerebrovascular disease, a retrospective study was undertaken regarding smoking habits of 187 patients (129 men and 58 women) with cerebral infarct of non-embolic origin and 85 patients (40 men and 45 women) with TIA (transient ischemic attacks). Each patient was matched with a control subject, of the same sex and age group, who showed no signs or symptoms of cerebrovascular disease. Results show a statistically significant association between smoking habits and cerebral infarcts only in male subjects who smoked more than 20 cigarettes a day.
Aged↗
[Use of ticlopidine in patients with acute non-embolic cerebral infarcts].
Different dosages, varying from 250 to 500 mg/die, of ticlopidine per os have been employed in 46 patients (32 men and 14 women), average age 66, who had been admitted for acute non-embolic cerebral infarction. In the two clinical examinations, effected on average 5.4 and 18.3 days after the admission, significant alterations in 9 among the considered items have been noticed, i.e.: central deficit of the VIIth cranial nerve, motor function and gait impairment, Babinski's sign, loss of sensibility, dysarthria, visual field defect, cerebellar signs, motor and/or receptive dysphasia. A global improvement of these clinical signs has been noticed on average in 48.2% of the patients, while an exacerbation has occurred in 2.1% of the cases. None of the patients who have been considered in this study has decreased or has shown relapses of ischemic cerebral attacks during the observation. The treatment with ticlopidine has been discontinued in 3 cases (6.5%) for the occurrence of temporary adverse side-effects.
Acute Disease↗
[Familial nature of acute cerebral vasculopathies of the ischemic type].
The frequency of cerebrovascular accidents and of risk factors including hypertension and diabetes was examined retrospectively in parents and siblings of 328 patients suffering from transient ischaemic attacks or non-embolic cerebral infarction and in a control group. The frequency of cerebrovascular accidents was significantly higher in the family of the patient compared to the family of the control. The relatives of the patient and the control had essentially the same frequency of diabetes, whereas hypertension was significantly more common in the family of the patient. When the relatives with one or both the risk factors were excluded and those with cerebrovascular accidents alone were compared, a greater frequency, though insignificant, was noted in the family of the patient. Hypertension and diabetes were more common in the relatives of the patient than in the control but this difference was not statistically significant. The significant excess of cerebrovascular accidents in the family of the patients suffering from transient ischaemic attacks and non embolic cerebral infarction cannot exclusively be attributed to the greater frequency of diabetes and hypertension.
Acute Disease↗
[Nyctohemeral incidence of acute cerebral vasculopathies].
The time of onset of the neurological symptomatology was studied retrospectively in 258 patients, 107 (41%) autopsized, affected by non embolic cerebral infarction (172 cases), cerebral haemorrhage (52 cases) and subarachnoid haemorrhage (24 cases). In the patients suffering from cerebral infarction or haemorrhage the symptomatology began more frequently in the morning hours (from 6 to 12 a.m.) while it was comparatively rare in the night (from 00 to 06 am.). and evening hours (from 6 to 12 p.m.). This difference was significant (p less than 0.01) at the chi-squared test. The patients with subarachnoid haemorrhage showed a more homogeneous distribution with a higher but not significant frequency in the morning hours. The nyctohemeral distribution does not significantly differ in the patients affected by cerebral infarction, cerebral haemorrhage and subarachnoid haemorrhage. The time of onset of the neurological symptomatology shows no significant variation in the patients with cerebral and subarachnoid haemorrhage after dividing them in normotensives and hypertensives, while in the hypertensive patients with cerebral infarction a significant higher frequency of strokes was observed in the night hours (from 00 to 06 a.m.).
Acute Disease↗
[Dyslipidemias and ischemic cerebral vasculopathies].
The serum cholesterol and triglycerid levels have been studied in 50 patients affected by transient ischaemic attacks (TIA) and in 89 patients suffering from cerebral infarction of non embolic origin. In 25 patients with TIA and in 59 patients with cerebral infarction, the HDL-cholesterol level and the HDL-cholesterol and total cholesterol ratio have also been determined. Every patient was matched with a control of the same age and sex for statistical proposal. The mean total cholesterol concentration was significantly higher in the male patients affected by TIA and cerebral infarction. Dividing the patients according to age, the mean total cholesterol level remained significantly higher only in the male patients with TIA under the age of 60. The mean triglycerid concentration was significantly higher as compared with the controls in the male patients with TIA under the age of 50 and in the female patients with TIA aged from 60 to 70. The HDL-cholesterol level, though lower than in controls, showed no significant variation both in patients with TIA and with cerebral infarction, excepting the male patients affected by cerebral infarction over the age of 70. The HDL-cholesterol and total cholesterol ratio was insignificantly lower than in controls both in TIA and in infarct patients. These results seem to emphasize the role of total serum cholesterol level in the pathogenesis of ischaemic cerebrovascular diseases particularly in the male patients under the age of 60. Less striking appears to be the role of serum triglycerid level. Finally we can't show a significant HDL-cholesterol reduction in our patients as compared with controls.
Age Factors↗
[Hematocrit value and hemoglobin concentration as possible risk factors in non-embolic acute cerebral infarcts].
The hematocrit and the concentration of hemoglobin have been studied in 197 patients (125 men and 72 women) suffering from acute cerebral infarction not due to embolism. The results have been analysed statistically and compared to those of a control group formed by 123 neurologic patients (68 men and 55 women) chosen at random, belonging to the same age range and with no cerebrovascular disease. The hematocrit was significantly higher in the patients who had a cerebral stroke of a non-embolic origin, both males and females, than in the control group, although it was within normal limits. As far as the concentration of hemoglobin is concerned, there is a significant statistical difference between patients with and without cerebral infarction, but only for the female patients.
Adult↗
[The blood level of uric acid as a risk factor in transient cerebral ischemic attacks and in non-embolic acute cerebral infarct].
The serum uric acid level has been determined in 300 patients, both males and females. 125 of these suffered from transient cerebral ischaemic attacks and 175 from atherothrombotic brain infarction. The values obtained were compared with those determined, with the same technique, in a control group of patients with neurologic diseases, chosen at random, and with no clinical finding or historical data of cerebrovascular and/or cardiac disease. No significant statistical difference has been observed between the mean serum uric acid level in the patients with transient ischaemic attacks, or brain infarction, and the control group. All the patients examined were divided according to sex and age. As far as sex was concerned, males suffering from cerebral transient or completed focal ischaemia, had on average a lower serum uric acid level compared to the control group. The opposite happened with females. As far as age was concerned, significantly high serum uric acid levels, compared to the control group, were observed in women with either transient ischaemic attacks or brain infarction, but only in those whose age range was between 50 and 60. In conclusion, from this study, hyperuricemia does not appear to be a high risk factor in ischaemic cerebrovascular diseases.
Adult↗
[Hematocrit and hemoglobin in the pathogenesis of transient cerebral ischemic attacks].
The hematocrit and the concentration of hemoglobin have been studied in 77 patients (42 men and 35 women) affected by transient cerebral ischaemic attacks involving carotid or vertebral-basilar arterial system. The results have been analysed statistically and compared to those of a control group, formed by 123 neurologic patients (68 men and 55 women) chosen at random, belonging to the same age range, and with no acute or chronic cerebrovascular disease. The hematocrit and the concentration of hemoglobin, although within normal limits, were significantly higher than in the control group only in the male patients with transient cerebral ischaemic attacks.
Adult↗