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  • 1
    Online Resource
    Online Resource
    Herpes simplex virus encephalitis: cranial magnetic resonance imaging and neuropathology in a mouse model
    Elsevier BV ; 1998
    In:  Neuroscience Letters Vol. 248, No. 1 ( 1998-5), p. 13-16
    Details
    In: Neuroscience Letters, Elsevier BV, Vol. 248, No. 1 ( 1998-5), p. 13-16
    Type of Medium: Online Resource
    ISSN: 0304-3940
    URL: Article
    DOI: 10.1016/S0304-3940(98)00319-X
    Language: English
    Publisher: Elsevier BV
    Publication Date: 1998
    detail.hit.zdb_id: 1498535-4
    SSG: 12
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  • 2
    Online Resource
    Online Resource
    Systemic lymphoma in patients with the initial diagnosis of primary central nervous system lymphoma: a report of two cases
    Springer Science and Business Media LLC ; 1999
    In:  Journal of Neurology Vol. 246, No. 9 ( 1999-9-22), p. 855-857
    Details
    In: Journal of Neurology, Springer Science and Business Media LLC, Vol. 246, No. 9 ( 1999-9-22), p. 855-857
    Type of Medium: Online Resource
    ISSN: 0340-5354 , 1432-1459
    URL: Article
    DOI: 10.1007/s004150050471
    RVK:
    XA 10000
    Language: Unknown
    Publisher: Springer Science and Business Media LLC
    Publication Date: 1999
    detail.hit.zdb_id: 1421299-7
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  • 3
    Online Resource
    Online Resource
    Intravenous Thrombolysis With Recombinant Tissue Plasminogen Activator for Acute Hemispheric Stroke : The European Cooperative Acute Stroke Study (ECASS)
    American Medical Association (AMA) ; 1995
    In:  JAMA Vol. 274, No. 13 ( 1995-10-04), p. 1017-
    Details
    In: JAMA, American Medical Association (AMA), Vol. 274, No. 13 ( 1995-10-04), p. 1017-
    Type of Medium: Online Resource
    ISSN: 0098-7484
    URL: Article
    DOI: 10.1001/jama.1995.03530130023023
    RVK:
    XA 10000
    Language: English
    Publisher: American Medical Association (AMA)
    Publication Date: 1995
    detail.hit.zdb_id: 2958-0
    detail.hit.zdb_id: 2018410-4
    SSG: 5,21
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  • 4
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    Online Resource
    Controlled Safety Study of a Hemoglobin-Based Oxygen Carrier, DCLHb, in Acute Ischemic Stroke
    Ovid Technologies (Wolters Kluwer Health) ; 1999
    In:  Stroke Vol. 30, No. 5 ( 1999-05), p. 993-996
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 30, No. 5 ( 1999-05), p. 993-996
    Abstract: Background and Purpose —Diaspirin cross-linked hemoglobin (DCLHb) is a purified, cell-free human hemoglobin solution. In animal stroke models its use led to a significant reduction in the extent of brain injury. The primary objective of this study was to evaluate the safety of DCLHb in patients with acute ischemic stroke. Methods —DCLHb or saline was administered to 85 patients with acute ischemic stroke in the anterior circulation, within 18 hours of onset of symptoms, in a multicenter, randomized, single-blind, dose-finding, controlled safety trial, consisting of 3 parts: 12 doses of 25, 50, and 100 mg/kg DCLHb over 72 hours. Results —DCLHb caused a rapid rise in mean arterial blood pressure. The pressor effect was not accompanied by complications or excessive need for antihypertensive treatment. Two patients in the 100 mg/kg group had adverse events that were possibly drug related: one suffered fatal brain and pulmonary edema, the other transient renal and pancreatic insufficiency. Multivariate logistic regression analysis showed that a severe stroke at baseline and treatment with DCLHb (OR, 4.0; CI, 1.4 to 12.0) were independent predictors of a worse outcome (Rankin Scale score of 3 to 6) at 3 months. Conclusions —Outcome scale scores were worse in the DCLHb group, and more serious adverse events and deaths occurred in DCLHb-treated patients than in control patients. We recommend that additional safety studies be performed, preferably with a second generation, genetically engineered hemoglobin.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/01.STR.30.5.993
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1999
    detail.hit.zdb_id: 1467823-8
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  • 5
    Online Resource
    Online Resource
    Decompressive Craniectomy for Cerebral Infarction : An Experimental Study in Rats
    Ovid Technologies (Wolters Kluwer Health) ; 1995
    In:  Stroke Vol. 26, No. 2 ( 1995-02), p. 259-264
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 26, No. 2 ( 1995-02), p. 259-264
    Abstract: Background and Purpose Acute ischemia in the territory of the carotid artery can lead to massive cerebral edema with raised intracranial pressure and progression to coma and death due to uncal, cingulate, or tonsillar herniation. Thus far, only anecdotal experience with supratentorial ischemia treated by decompressive craniectomy has been reported, and there are no published experimental data dealing with this kind of therapy in acute supratentorial stroke. In this study, we present our results on the effect of decompressive craniectomy in an endovascular model of cerebral infarction in rats. Methods Focal cerebral ischemia was induced in 50 rats using an endovascular occlusion technique of the middle cerebral artery. Decompressive craniectomy was performed in 30 animals: in 15 animals after 1 hour and in the remaining 15 animals 24 hours after vessel occlusion. Twenty animals were not treated by decompressive craniectomy (control group). Results Mortality in the nontreated group was 35%, whereas none of the animals treated by decompressive craniectomy died. Neurological behavior, weight loss, and infarction size were all significantly better in the animals treated by decompressive craniectomy, regardless of whether they had been treated after 1 or 24 hours ( P 〈 .01). Conclusions Our results suggest that decompressive craniectomy for cerebral ischemia not only reduces mortality but also significantly improves outcome and reduces infarction size, probably because of increased perfusion pressure through leptomeningeal collaterals. This experimental study suggests that a controlled study of decompressive craniectomy in patients with acute internal carotid or middle cerebral artery occlusion would be worthwhile. By performing decompressive craniectomy in a small, selected group of patients, neurosurgeons may play an important role in the management of these patients.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/01.STR.26.2.259
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1995
    detail.hit.zdb_id: 1467823-8
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  • 6
    Online Resource
    Online Resource
    Does Arterial Recanalization Improve Outcome in Carotid Territory Stroke?
    Ovid Technologies (Wolters Kluwer Health) ; 1995
    In:  Stroke Vol. 26, No. 4 ( 1995-04), p. 581-587
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 26, No. 4 ( 1995-04), p. 581-587
    Abstract: Background and Purpose We sought to determine whether early ( 〈 8 hours) or delayed (8 to 24 hours) recanalization after stroke may be an independent variable in the improvement of clinical outcome in patients with occlusion of the middle cerebral artery. Methods We prospectively studied 77 patients by combined Scandinavian Stroke Scale score at admission, repeated computed tomography and angiography before and after thrombolytic treatment at 〈 8 hours after stroke onset, and transcranial Doppler ultrasound 24 hours later. We tested an association between clinical and neuroradiological baseline characteristics, recanalization, and outcome as assessed by the modified Rankin Scale 4 weeks after stroke and determined the effect of recanalization on mortality and good outcome (Rankin Scale grades 0 to 3) by multiple logistic regression analyses. Results Recanalization rates at 8 and 24 hours after stroke correlated with sites of occlusion (middle cerebral artery branch, 73% and 73%; trunk, 27% and 38%, respectively; intracranial internal carotid artery bifurcation, 14% and 14%; P =.002), collaterals (good, 43% and 51%, respectively; scarce, 17% and 19%, respectively; P =.01), and Scandinavian Stroke Scale score at admission ( P =.002). Six of 7 patients with delayed recanalization had good outcomes. Recanalization at 〈 8 hours after symptom onset had no independent predictive value for good outcome ( P =.69). Recanalization at 24 hours increased the proportion of good outcomes from 23% to 75% in a subgroup of patients. Recanalization did not independently affect mortality ( P 〉 .15). Conclusions Even if delayed, arterial recanalization may improve clinical outcome in a subgroup of patients with middle cerebral artery occlusion.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/01.STR.26.4.581
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1995
    detail.hit.zdb_id: 1467823-8
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  • 7
    Online Resource
    Online Resource
    Thrombolytic Therapy of Acute Basilar Artery Occlusion : Variables Affecting Recanalization and Outcome
    Ovid Technologies (Wolters Kluwer Health) ; 1996
    In:  Stroke Vol. 27, No. 5 ( 1996-05), p. 875-881
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 27, No. 5 ( 1996-05), p. 875-881
    Abstract: Background and Purpose Thrombolysis may reduce mortality after acute basilar artery (BA) occlusion. We intended to find variables affecting recanalization and clinical outcome in patients with BA occlusion undergoing thrombolytic therapy. Methods We analyzed in retrospect the clinical and angiographic data of a consecutive series of 51 patients treated with intra-arterial urokinase (n=44; 0.3 to 1.5 mIU) or intravenous or intra-arterial recombinant tissue plasminogen activator (n=7; 22 to 100 mg). We identified effective variables by multiple logistic regression analyses and univariate tests. Results Sites of occlusion were the caudal (n=23), middle (n=18), and distal (n=10) segments of the BA. The pathogenesis was embolism in 35 and local atherothrombosis in 16 patients. Collateral circulation was good in 32 patients and poor or absent in 19 patients. Recanalization was achieved in 26 of 51 (51%) patients and was associated with occlusions of embolic etiology ( P =.0025). Mortality was 46% (12/26) in the recanalization group and 92% (23/25) in the nonrecanalization group ( P =.0004). Other independent variables affecting mortality were length of BA obstruction ( P =.0011), age ( P =.0008), and collateral state ( P =.0454). After follow-up (median, 32 months), 10 of the 16 survivors were only minimally impaired, with a Barthel Index score of 95 or greater; 5 patients were moderately and 1 severely disabled. Conclusions Recanalization of acute BA occlusion reduces mortality significantly. Length of BA obstruction and state of the collaterals are additional independent variables affecting survival. Young patients with monosegmental embolic occlusion of the BA seem to have the best chance to considerably profit from thrombolysis.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/01.STR.27.5.875
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1996
    detail.hit.zdb_id: 1467823-8
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  • 8
    Online Resource
    Online Resource
    European Strategies for Early Intervention in Stroke (Part 1 of 2)
    S. Karger AG ; 1996
    In:  Cerebrovascular Diseases Vol. 6, No. 5 ( 1996), p. 315-319
    Details
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 6, No. 5 ( 1996), p. 315-319
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    URL: Article
    DOI: 10.1159/000108045
    Language: English
    Publisher: S. Karger AG
    Publication Date: 1996
    detail.hit.zdb_id: 1482069-9
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  • 9
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    Online Resource
    A Standardized MRI Stroke Protocol : Comparison with CT in Hyperacute Intracerebral Hemorrhage
    Ovid Technologies (Wolters Kluwer Health) ; 1999
    In:  Stroke Vol. 30, No. 4 ( 1999-04), p. 765-768
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 30, No. 4 ( 1999-04), p. 765-768
    Abstract: Background and Purpose —Diagnostic imaging in hyperacute ischemic stroke has been revolutionized by the introduction of diffusion- and perfusion-weighted MRI (DWI and PWI). CT, however, is still needed to exclude intracerebral hemorrhage (ICH). The purpose of our study was to determine the diagnostic accuracy of a standardized, multimodal MRI (mMRI) stroke protocol in the qualitative and quantitative assessment of hyperacute ICH ( 〈 6 hours). Methods —We investigated 9 patients with hyperacute ICH with CT followed immediately by a standardized mMRI stroke protocol (DWI, PWI [T2*-WI], FLAIR, T2-WI, and MRA). The time interval between MRI and symptom onset ranged from 3 hours to 5 hours 45 minutes. We analyzed and compared the size of the hematoma on CT and all mMRI images by semiautomatic volumetry. Results —ICH was unambiguously identified on the basis of all mMRI sequences. With increasing susceptibility effect (T2*-WI), the ICH, appearing as an area of hyperintensity with central signal loss, became qualitatively most evident. Regarding quantitation, T2*-WI overestimated (median and mean difference, 18.9%/17.8%; SD ς=24.4%) and DWI correlated best (median and mean difference, 3.97%/−4.36%; SD ς=37.42%) with hematoma size on CT. Conclusions —Multimodal stroke MRI is as reliable as CT in the assessment of hyperacute ICH. Therefore, additional CT is no longer necessary to rule out ICH in hyperacute stroke. The use of mMRI alone in the diagnostic workup of a hyperacute stroke patient saves time and costs while rendering all the critical information needed to initiate an optimal treatment.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/01.STR.30.4.765
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1999
    detail.hit.zdb_id: 1467823-8
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  • 10
    Online Resource
    Online Resource
    CT Angiography and Doppler Sonography for Emergency Assessment in Acute Basilar Artery Ischemia
    Ovid Technologies (Wolters Kluwer Health) ; 1999
    In:  Stroke Vol. 30, No. 3 ( 1999-03), p. 606-612
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 30, No. 3 ( 1999-03), p. 606-612
    Abstract: Background and Purpose —Both Doppler sonography (DS) and spiral CT angiography (CTA) are noninvasive vascular assessment tools with a high potential for application in acute cerebral ischemia. The usefulness of CTA for vascular diagnosis in acute basilar artery (BA) ischemia has not yet been studied. Methods —We prospectively studied 19 patients (mean±SD age, 58±11 years) with clinically suspected acute BA occlusion by DS and CTA. Prior extracranial and transcranial DS was performed in all but 1 patient, with DS 4 hours after CTA. In 6 of 19 patients, we performed digital subtraction angiography. Results —CTA was diagnostic in all but 1 patient. CTA revealed complete BA occlusion in 9 patients and incomplete BA occlusion with some residual flow in 2 patients. A patent BA was shown in 7 patients. Because of severe BA calcification, CTA results were inconclusive in 1 patient. DS was diagnostic in only 7 of 19 patients, indicating certain BA occlusion in 3 patients and BA patency in 4 patients. In an additional 9 patients, the results of DS were inconclusive. DS was false-negative in 2 patients with distal BA occlusion shown by CTA and digital subtraction angiography. In 1 patient with DS performed after CTA, recanalization was demonstrated. In addition to the diagnosis or exclusion of BA occlusion, CTA provided information on the exact site and length of BA occlusion and collateral pathways. In our series, CTA results prompted indication for intra-arterial thrombolysis in 5 patients. Conclusions —CTA was superior to DS in the assessment of BA patency in patients with the syndrome of acute BA ischemia in terms of feasibility and conclusiveness, particularly in cases with distal BA occlusion. Our study confirmed the usefulness of combined extracranial and transcranial DS in the diagnosis and exclusion of proximal BA occlusion.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/01.STR.30.3.606
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1999
    detail.hit.zdb_id: 1467823-8
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