Abstract:
UNLABELLED:The pathophysiology of postischemic encephalopathy is complex, and includes tissue acidosis, edema, hypoperfusion, membrane dysfunction, impaired energy production, and possibly hypermetabolism. We tested the hypothesis that this multifactorial clinical problem must be approached with multifaceted therapy, with specific treatment aimed at each of the above postischemic changes. Eighteen minutes of complete global brain ischemia was produced with a higher pressure neck cuff in pigtailed monkeys. Control treatment postischemia (n = 9): 1) Normotension (MAP greater than or equal to 80 mmHg) restored within 2 min postischemia, 2) controlled ventilation for 24 hours with PaCO2 = 25 mmHg, 3) normothermia, and 4) phenytoin seizure prophylaxis from 20 hours postischemia. Experimental treatment (n = 10): Control treatment plus the following modifications: 1) Hemodilution to hematocrit 25% at 1-4 min postischemia, 2) brief hypertension (MAP 130 mmHg for 5 min) after accomplished hemodilution, 3) hypothermia for 6 hours, 4) pentobarbital 30 mg/kg i.v., 5) dexamethasone 4 mg/kg i.v. Outcome was evaluated at 96 hours postischemia by overall performance categories (OPC) (OPC I = normal, OPC V = brain death), neurologic deficit (ND) scores (100% ND = brain death, 0% ND = normal), and histologic damage scores of the brains. RESULTS:Brain death developed in 1/9 control and 0/10 treated animals. The number of awake monkeys (OPC I and II) at 96 hours postischemia was significantly higher in the treated group (7/10) than in the control group (2/9) (p = 0.05). The median ND scores for the two groups were 16 and 35% respectively (p greater than 0.05). The results strongly suggest that postischemic treatment may be beneficial and that a multifaceted therapeutic approach is worth pursuing.
journal_name
Strokejournal_title
Strokeauthors
Gisvold SE,Safar P,Rao G,Moossy J,Kelsey S,Alexander Hdoi
10.1161/01.str.15.5.803subject
Has Abstractpub_date
1984-09-01 00:00:00pages
803-12issue
5eissn
0039-2499issn
1524-4628journal_volume
15pub_type
杂志文章相关文献
STROKE文献大全abstract::Cardioembolic stroke is a complex disease resulting from the interaction of numerous factors. Using data from Genes Affecting Stroke Risk and Outcome Study (GASROS), we show that a multivariate predictive model built using Bayesian networks is able to achieve a predictive accuracy of 86% on the fitted values as comput...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.108.533273
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Coffee and tea consumption could potentially reduce the risk of stroke because these beverages have antioxidant properties, and coffee may improve insulin sensitivity. We examined the associations of coffee and tea consumption with risk of stroke subtypes. METHODS:We used prospective data from t...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.107.504183
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Stroke has global importance and it causes an increasing amount of human suffering and economic burden, but its management is far from optimal. The unsuccessful outcome of several research programs highlights the need for reliable data on which to plan future clinical trials. The Virtual Internat...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.106.473579
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVES:Cerebrovascular mortality has declined in the general population of Sweden. The objective of the present study was to investigate causes of death among stroke patients in a long-term perspective. RESEARCH DESIGN AND METHODS:A population-based study was conducted of first-ever strokes in the municipality of ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000129333.87858.4f
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The remaining limitations of ultrasonographic imaging in accurately quantifying internal carotid stenosis or diagnosing internal carotid occlusion may be overcome by enhancing the echogenicity of flowing arterial blood with contrast agents. This study assessed the usefulness of the intravenous (t...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.25.2.385
更新日期:1994-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Systemic administration of Toll-like receptor (TLR) 4 and TLR9 agonists before cerebral ischemia have been shown to reduce ischemic injury by reprogramming the response of the brain to stroke. Our goal was to explore the mechanism of TLR-induced neuroprotection by determining whether a TLR7 agoni...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.111.641522
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The objectives of the present study were to: (1) noninvasively identify white matter reorganization and monitor its progress within 6 weeks after the onset of stroke; and (2) quantitatively investigate the effect of recombinant human erythropoietin treatment on this structural change using in viv...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.108.527713
更新日期:2009-03-01 00:00:00
abstract::As a preliminary investigation into the cerebral effects of mechanical cardiac assist devices, using transcranial Doppler ultrasonography I examined the basal cerebral arteries in three patients placed on an intra-aortic balloon pump. Unassisted systoles had normal blood velocities and waveforms. When the pump was in ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.21.3.484
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Recombinant tissue plasminogen activator (rtPA; Actilyse) is not as widely used in clinical practice as it could be. Have new data since 1995 strengthened the evidence sufficiently to justify more widespread use of rtPA? METHODS:We performed a sequential year-to-year cumulative meta-analysis of ...
journal_title:Stroke
pub_type: 杂志文章,meta分析
doi:10.1161/01.STR.0000072513.72262.7E
更新日期:2003-06-01 00:00:00
abstract::Glycosylated hemoglobin concentration (GHb), which is considered an indication of glycemia over the preceding several months, was examined in 50 patients hospitalized for recent stroke or transient ischemic attacks (TIA), and compared to that in several reference populations. Patients with stroke or TIA had GHb (mean ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.13.3.356
更新日期:1982-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We aimed to describe the frequency and characteristics of acute ischemic stroke and transient ischemic attacks presenting predominantly with amnesia (ischemic amnesia) and to identify clinical clues for differentiating them from transient global amnesia (TGA). METHODS:We retrospectively analyzed...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.117.017420
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Current US guideline statements regarding primary and secondary cardiovascular risk prediction and prevention use absolute risk estimates to identify patients who are at high risk for vascular disease events and who may benefit from specific preventive interventions. These guidelines do not expli...
journal_title:Stroke
pub_type: 杂志文章,实务指引
doi:10.1161/STR.0b013e31825bcdac
更新日期:2012-07-01 00:00:00
abstract::Brief episodes of ischemia can protect against subsequent damaging ischemic events; however, the molecular mechanisms responsible for protection are poorly understood. Identifying genes involved in this process could provide insight into cell survival and treatment of stroke. We developed a murine model of ischemic pr...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000143735.89281.bb
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:It remains uncertain whether lower dose intravenous tissue-type plasminogen activator (tPA) for stroke is as effective and safe as the standard dose. METHODS:We analyzed data from the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China (TIMS-China). Patients who were treate...
journal_title:Stroke
pub_type: 杂志文章,多中心研究
doi:10.1161/STROKEAHA.114.005989
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Urinary incontinence in the acute stage of stroke is seen as a predictor of death, severe disability, and an important factor on hospital discharge destination. Therefore, it is an important measure of stroke severity that not only affects the lives of stroke survivors but also those of caregivers. SUMMARY ...
journal_title:Stroke
pub_type: 杂志文章,评审
doi:10.1161/01.str.29.2.524
更新日期:1998-02-01 00:00:00
abstract::The gap between existing knowledge and the patient care provided in stroke has become more apparent. The translational gap is evidence of our scientific progress, but the sheer magnitude of our implementation gap is astounding. For instance, almost 5 decades ago we recognized the risk factors for stroke, yet in Canada...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.107.492793
更新日期:2007-12-01 00:00:00
abstract::In 20 patients with acute major cerebral arterial occlusion, follow-up angiograms were obtained to inspect the occluded artery. These angiograms were compared with brain scans in the fourth week after the stroke. The angiograms revealed that frequent recanalization of the occluded arteries occurred within a week after...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.6.2.132
更新日期:1975-03-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We designed a prospective sequential pretreatment and posttreatment MRI study to assess the relation between neuroimaging parameters and clinical outcome in patients treated with intravenous recombinant tissue-type plasminogen activator (rtPA). METHODS:Patients with symptoms of acute hemispheric...
journal_title:Stroke
pub_type: 临床试验,杂志文章
doi:10.1161/01.str.0000053850.64877.af
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Our aim was to estimate the cost-effectiveness of transferring patients with intracerebral hemorrhage from centers without specialized neurological intensive care units (neuro-ICUs) to centers with neuro-ICUs. METHODS:Decision analytic models were developed for the lifetime horizons. Model input...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.114.006653
更新日期:2015-01-01 00:00:00
abstract::MRI is becoming the imaging modality of choice in patients with ischemic cerebrovascular disease although CT is still the test of choice to exclude acute hemorrhagic stroke. We have briefly reviewed characteristic features of ischemic and hemorrhagic cerebrovascular disease as well as vascular anomalies as seen on MRI...
journal_title:Stroke
pub_type: 杂志文章,评审
doi:10.1161/01.str.20.9.1279
更新日期:1989-09-01 00:00:00
abstract::A randomized controlled trial was conducted to examine the effects of interdisciplinary team care on acute hospitalized stroke patients. After obtaining baseline information on 42 stroke victims receiving conventional care in a general hospital, 130 stroke patients were stratified and randomly assigned either to Tradi...
journal_title:Stroke
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.str.15.5.864
更新日期:1984-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Improvements in cardiac surgery mortality and morbidity have focused interest on the neurological injury such as stroke and cognitive decline that may accompany an otherwise successful operation. We aimed to investigate (1) the rate of stroke, new ischemic change on MRI, and cognitive impairment ...
journal_title:Stroke
pub_type: 临床试验,杂志文章
doi:10.1161/STROKEAHA.107.502989
更新日期:2008-05-01 00:00:00
abstract::Background and Purpose- Multifaceted quality improvement interventions of stroke care have been shown to improve hospital personnel adherence to evidence-based performance measures and subsequent stroke outcomes. This study aimed to evaluate the cost-effectiveness of a multifaceted quality improvement intervention for...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.119.027980
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Effects of anoxic stress on cerebrovascular responses to calcitonin gene-related peptide (CGRP) have not been examined previously. We determined the effects of total global ischemia on cerebral arteriolar responses to CGRP in newborn pigs. METHODS:Piglets were anesthetized and ventilated with a ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.27.1.134
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Physical and psychological characteristics in adolescence are associated with subsequent stroke risk. Our aim is to investigate their relevance to length of hospital stay and risk of second stroke. METHODS:Swedish men born between 1952 and 1956 (n=237 879) were followed from 1987 to 2010 using i...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.116.014265
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Stroke is the second leading cause of death in Japan. We sought to examine changes in stroke mortality rates by age, sex, and birth cohorts from 1950 to 1997. METHODS:The numbers of deaths from stroke and the population by age and sex in subjects aged 55 to 79 years between 1950 and 1997 were ob...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.32.8.1745
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Hemodynamic insult by bilateral common carotid artery ligation has been shown to induce aneurysmal remodeling at the basilar terminus in a rabbit model. To characterize critical hemodynamics that initiate this remodeling, we applied a novel hemodynamics-histology comapping technique. METHODS:Eig...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.110.585992
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Patient selection is crucial in the endovascular treatment of acute ischemic stroke patients. Baseline computed tomographic (CT) images, evaluated with the Alberta Stroke Program Early CT Scale (ASPECTS), are considered significant predictors of outcome. In this study, we evaluated CT images and ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.113.001068
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Severe cerebral edema is associated with poor outcome in patients with acute stroke. Experimental studies suggest that astrocytic endothelin-1 (ET-1) has deleterious effects on water homeostasis, cerebral edema, and blood brain barrier (BBB) integrity, which contribute to more severe ischemic bra...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.107.495044
更新日期:2008-07-01 00:00:00
abstract::Reduction in cerebral blood flow (CBF) following global ischemia has been implicated as a pathogenetic mechanism in progressive brain damage seen after restoration of effective cardiac action and cerebral perfusion pressure. There are serious limitations to many of the techniques for measuring regional cerebral blood ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.12.1.66
更新日期:1981-01-01 00:00:00