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[Neuroophthalmic characteristics of patients with transient cerebrovascular disorders].

Results of complex neuroophthalmological examinations of a group of patients with transient disturbances of the cerebral circulation are considered and discussed. On the basis of clinical, rheoencephalographic, electroencephalographic, ophthalmocalibrometric, ophthalmodynamometric, biomicroscopic (of the conjunctiva vessels) and other ophthalmoscopic findings it has been concluded that the transient disturbances of the cerebral circulation can be differentiated both topically and pathogenetically: this may serve as a basis for individualized pathogenetic therapy.

Adult↗

[So-called presclerosis (developing cerebral ischemia)].

The complaints of 400 patients who were sent by their general practitioners to our hospital are enumerated in table 1 according to thier frequency (33 items). Three groups of complaints stand out: a) disturbances of memory and concentration b) nervousness - inward restlessness - increased irritability c) fatigue - decrease of performance. In the earlier literature similar syndromes were described as signs of the diminution of cerebral performance. If they appeared in old persons they were considered as an expression of a (physio-logical?) decrease of neurons. In middle-aged men the same syndrome was considered as sign of a premature cerebral arteriosclerosis. Recent investigations have shown that a decrease of cerebral performance is often due to a degenerative process of Alzheimer's type. In many cases it is difficult to decide concerning which of the three basic processes we have to take into consideration if a diminution in cerebral performance occurs. Presented are: Cues for diagnosis, differential diagnosis and treatment of the syndrome often seen in general practice today.

Aged↗

Cerebral hemodynamics evaluation.

The cerebral hemodynamic evaluation is the embodiment of a system approach to the hemodynamic factors that affect brain blood flow. The stresses employed are those encountered in everyday living. The instruments are simple and the method is basic. The importance of the cardiovascular response to the upright position and of brain perfusion to head motion deserves close attention in the clinical setting. The CHE complements the angiogram, the CT scan, and CT-rBBC studies by addressing the system and arterial hemodynamic factors affecting brain circulation. The CT-rBBC studies have given greater validity and direction to noninvasive and electrophysiologic testing because the ultimate concern is brain perfusion and function and not the angiogram. This combination of techniques has defined the role of the dynamic arterial obstruction and the vertebral artery in the hemodynamics of the brain. The cerebral hemodynamic evaluation is an integral part of the physiologic approach to the diagnosis and treatment of brain ischemia.

Aged↗

Ocular pneumoplethysmography in the evaluation of carotid stenosis.

Ocular pneumoplethysmography is a noninvasive technique for detecting carotid stenosis by measurement of ophthalmic artery pressure. The results of the test were studied in 227 patients who underwent biplane angiography. The overall accuracy was 93% in the correct identification of hemodynamically significant stenosis (defined as a 60% or greater decrease in luminal diameter). The good result of this single test makes it our choice of noninvasive methods for both screening and follow-up study of carotid occlusive disease.

Carotid Arteries↗