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Biomedical subjects

V U Fritz

Publications and source records attributed to V U Fritz.

At least 37 records · Page 2Linked to original sources
PubMed1988

Therapy for isolated, low and high grade symptomatic carotid artery stenosis.

This study evaluates whether medical therapy alone can achieve satisfactory results in the treatment of low grade carotid stenosis or ulcerated plaques. Out of 525 patients presenting with transient or minor strokes, 64 were found with unilateral extracranial vascular disease as the sole potential source for their neurological symptoms. Utilizing arteriographic criteria, 35 patients with ulcerated plaques or carotid artery stenosis of less than 50% luminal artery diameter were treated conservatively with aspirin and dipyridamole (300 mg/day each). Twenty-nine patients with unilateral internal carotid artery stenosis of greater than 50% luminal artery diameter were treated by means of carotid endarterectomy. Follow-up in the two groups for a mean period of 24-26 months revealed no major strokes or neurological deaths in either group. Myocardial infarction was the major cause of death. Two patients developed subsequent transient ischemic attacks, and one a minor stroke with total recovery in the conservatively treated group. All became asymptomatic when warfarin replaced aspirin therapy. The findings in this study confirmed that "low grade" stenoses can be safely treated by medical measures alone.

Aged↗
PubMed1987

Diabetes as risk factor for transient ischaemic attacks as opposed to strokes.

This study examined the hypothesis that diabetes mellitus predisposes the brain to irreversible ischaemic damage rather than to reversible transient ischaemic attacks. Of 525 patients presenting with transient or minor strokes, 54 patients were found to have diabetes mellitus and 471 patients had no evidence of diabetes. The diabetic subgroup was significantly more hypertensive than the non-diabetic subgroup (P less than 0.001). In an overall comparison of the prevalence of strokes and transient ischaemic attacks in diabetic and non-diabetic subgroups, 26 (6.7%) of 388 patients with transient ischaemic attacks had diabetes mellitus, and 362 (93.3%) of 388 patients with transient ischaemic attacks were non-diabetic. Thus diabetes was not a significant risk factor for TIAs (P less than 0.001). However when the role of diabetes in causing strokes was assessed in all 525 patients evaluated in the study, 28 of 54 diabetics presented with strokes whereas 109 of 471 non-diabetics presented with strokes. Statistically diabetics were 3-4 times more likely to present with a stroke than non-diabetics (P less than 0.0001) in keeping with the findings in other centres. The findings of this study appear to support the hypothesis that diabetics are at a greater risk of permanent cerebral ischaemia without prior warning of a transient ischaemic event than their non-diabetic counterparts. It may be advisable to screen asymptomatic diabetic patients aggressively and to consider these patients as a high risk subgroup for potential stroke if extracranial carotid vascular disease is present.

Aged↗
PubMed1985

Neurological complications of systemic vasculitis. A report of 2 cases.

In up to 72% of patients with systemic vasculitis the neurological system may be involved. This may be peripheral or central (brain or spinal cord), and is usually due to infarction or a ruptured aneurysm. Diagnosis and evaluation are based peripherally on examination of a biopsy specimen or centrally on angiography. Therapy is usually with steroids and/or immunosuppressive agents. Two patients with systemic necrotizing vasculitis with unusual neurological complications are presented.

Adult↗
PubMed1984

Neck manipulation causing stroke. Case reports.

Neck manipulation may cause injury to the vertebrobasilar arterial system with resultant brainstem ischaemia or infarction. This complication has been recognized for many years, and although rarely reported in the literature is a well-recognized problem encountered by neurologists. This article describes 3 patients with this condition seen at the Johannesburg Hospital. The probable pathogenesis is that a thrombus occurs at a site of vertebral artery injury created by sudden sharp neck movement chiefly between the axis and atlas. This thrombus may propagate or embolize. The therapeutic role of anticoagulants is discussed.

Adult↗
PubMed1984

Fibromuscular dysplasia of the extracranial carotid arteries. Case reports.

Seven cases of fibromuscular dysplasia of the carotid artery are presented. Six of these patients presented with transient or fixed neurological deficit and 1 with intracranial haemorrhage. The uncertainty about the natural history of this condition is highlighted, and guidelines to the management of symptomatic patients as well as the more controversial incidentally diagnosed asymptomatic patient are outlined. A novel form of intra-operative use of a Grunzig balloon dilatation catheter in the management of fibromuscular dysplasia is presented.

Adult↗
PubMed1983

External carotid endarterectomy. Case reports.

In the presence of internal carotid artery occlusion, external carotid artery disease can produce neurological symptoms either by reducing flow in the collateral vessels to the circle of Willis, or by acting as a source for embolic disease. Five cases are described to illustrate the clinical presentations possible in this situation, and to demonstrate the symptomatic relief afforded by correctly selected external carotid endarterectomy.

Aged↗
PubMed1983

Motor neuron disease associated with carcinoma. A report of 2 cases.

Paraneoplastic complications are obscure and difficult to understand. The association of motor neuron disease and carcinoma may sometimes be more than coincidental, and 2 cases are described. One patient had motor neuron disease, limbic encephalitis (a recognized paraneoplastic disorder) and carcinoma of the oesophagus; the other had motor neuron disease and adenocarcinoma of the rectum. In the elderly male with motor neuron disease simple screening tests to exclude lymphoma and carcinoma of the lung, bowel and genito-urinary tract are advocated.

Adenocarcinoma↗
PubMed1981

Carotid phono-angiography and directional Doppler ultrasound in the assessment of carotid artery stenosis.

A combination of non-invasive tests consisting of Doppler ultrasound carotid velocity assessment, carotid phono-angiography and directional Doppler supra-orbital flow evaluation was used to detect internal carotid stenosis of 50% or more in patients with symptoms suggestive of cerebrovascular disease. When compared with contrast arteriography in 75 carotid arteries this battery of non-invasive tests detected 18 of 19 cases of carotid stenosis, resulting in a sensitivity of 95%. Three false-positive results yielded a specificity of 95%. The accuracy achieved with this non-invasive battery of tests suggested that clinical decisions are warranted on the basis of their results.

Angiography↗
PubMed1978

Bacillus cereus endocarditis. A case report.

Bacillus cereus may cause infective problems in compromised patients. No previous record of infective endocarditis due to this organism could be found. A 51-year-old White woman with B. cereus endocarditis after prosthetic mitral valve replacement is described. The problems of interpreting the significance of B. cereus bacteraemia, delayed diagnosis, and the inherent resistance of the organism are discussed.

Bacillus cereus↗