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  • 1
    Online Resource
    Online Resource
    High Intensity Transient Signals in Patients with Carotid Stenosis May Persist after Carotid Endarterectomy
    S. Karger AG ; 2004
    In:  Cerebrovascular Diseases Vol. 17, No. 2-3 ( 2004), p. 123-127
    Details
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 17, No. 2-3 ( 2004), p. 123-127
    Abstract: 〈 i 〉 Background: 〈 /i 〉 This study was undertaken to elucidate the natural history of high intensity transient signals (HITS) after carotid endarterectomy (CEA) and to determine whether this differs between patients with and without HITS detected preoperatively. 〈 i 〉 Methods: 〈 /i 〉 A 30-min transcranial Doppler (TCD) recording was performed to detect HITS in 141 patients at 0–1 h, 2–3 h, 4–6 h and 24–36 h following CEA. 104 of these patients also had 30-min TCD monitoring within 48 h prior to CEA. 〈 i 〉 Results: 〈 /i 〉 In the preoperative HITS-negative group, the proportion with postoperative HITS fell from 53% at 0–1 h to 17% at 24–36 h. In the preoperative HITS-positive group, the proportion with postoperative HITS remained steady (43% at 0–1 h, 52% at 24–36 h). During the 24–36 h postoperative epoch, 11 of 21 (52%) of the preoperative HITS-positive group had at least one HITS compared to 11 of 66 (17%) of the preoperative HITS-negative group (p = 0.001). In a multiple logistic regression analysis, preoperative HITS was the only factor associated with persistent postoperative HITS. 〈 i 〉 Conclusion: 〈 /i 〉 The proportion of cases with postoperative HITS diminished in the 24–36 h after CEA except for preoperative HITS-positive patients. About half of our patients undergoing CEA with preoperative HITS might have another embolic source.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    URL: Article
    DOI: 10.1159/000075780
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2004
    detail.hit.zdb_id: 1482069-9
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  • 2
    Online Resource
    Online Resource
    White Matter Medullary Infarcts: Acute Subcortical Infarction in the Centrum ovale
    S. Karger AG ; 1998
    In:  Cerebrovascular Diseases Vol. 8, No. 5 ( 1998), p. 289-295
    Details
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 8, No. 5 ( 1998), p. 289-295
    Abstract: Acute infarction confined to the territory of the white matter medullary arteries is a poorly characterised acute stroke subtype. 22 patients with infarction confined to this vascular territory on CT and/or MRI were identified from a series of 1,800 consecutive admissions to our stroke unit (1.2%) between August 1993 and March 1997. 19 patients had small infarcts ( 〈 1.5 cm maximum diameter) and 3 large infarcts ( 〉 1.5 cm). Small infarcts were associated with a history of smoking (69%), hypertension (58%), and hyperlipidaemia (37%), and less frequently with atrial fibrillation (21%). Significant ( 〉 50%) ipsilateral carotid stenosis (16%) was a less frequent finding in this group. Patients most commonly presented with weakness and/or sensory disturbance affecting mainly the upper limbs, but dysarthria, dysphasia, and ataxia were also seen. Large infarcts were infrequent in our series, but did not differ significantly from small infarcts with respect to clinical presentation or risk factor profiles (p 〉 0.05 for all comparisons). The majority of symptomatic patients with white matter medullary infarcts are associated with small ( 〈 1.5 cm diameter) lesions and a risk factor profile consistent with small vessel disease. More data are required to elucidate the mechanism of larger ( 〉 1.5 cm) infarcts. Because of the potential overlap between white matter medullary infarcts and internal watershed infarcts, suggested criteria for each are presented.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    URL: Article
    DOI: 10.1159/000015868
    Language: English
    Publisher: S. Karger AG
    Publication Date: 1998
    detail.hit.zdb_id: 1482069-9
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  • 3
    Online Resource
    Online Resource
    Paracentral Strip Infarcts of the Middle Cerebral Artery: Borderzone Ischaemia or Cortical Artery Occlusion?
    S. Karger AG ; 2009
    In:  Cerebrovascular Diseases Vol. 27, No. 3 ( 2009), p. 215-222
    Details
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 27, No. 3 ( 2009), p. 215-222
    Abstract: 〈 i 〉 Background and Purpose: 〈 /i 〉 We have noted the presence of small strip-like infarcts involving the cortex within the interdivisional territory of the middle cerebral artery (MCA) and sometimes extending to the periventricular region. The incidence in a stroke unit population, mechanisms, clinical expression and prognosis of patients with these cortical infarcts are unknown. To clarify these issues we retrospectively and prospectively identified these patients in our own stroke unit population. 〈 i 〉 Methods: 〈 /i 〉 Patients were identified retrospectively and prospectively from the Austin Hospital Stroke Unit from March 2001 to May 2007. All were selected on the basis of the recent onset of an acute neurological deficit with imaging showing strip infarction within the MCA territory. Clinical features were recorded and the mechanism of infarction was classified based on the TOAST criteria from standard investigations. 〈 i 〉 Results: 〈 /i 〉 From 4,274 acute stroke admissions, there were 24 patients (0.6%), 12 males and 12 females (mean age 75 years; range 44–92 years) with CT or MRI showing characteristic linear infarction in the middle cerebral territory. In most cases, infarction was adjacent to the central sulcus. Common clinical features included mild-to-moderate hemiparesis with cortical signs. The most common TOAST criterion mechanism categories were artery-to-artery or cardiac embolism. It is postulated that this resulted in either isolated small cortical artery branch occlusion or borderzone infarction between superior and inferior divisions of the MCA due to more proximal large-artery vessel occlusion. Prognosis was good. 〈 i 〉 Conclusions: 〈 /i 〉 We describe the phenotypic expression, postulated mechanisms and prognosis of strip-like infarcts between the superior and inferior MCA divisions. The likely artery-artery or cardio-embolic mechanisms should prompt clinicians to search for an embolic source. While the prognosis of the syndrome is generally good, its recognition may allow specific therapies to be developed to improve clinical outcomes further.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    URL: Article
    DOI: 10.1159/000196818
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2009
    detail.hit.zdb_id: 1482069-9
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  • 4
    Online Resource
    Online Resource
    Hyperperfusion Post-Endarterectomy
    S. Karger AG ; 1994
    In:  Cerebrovascular Diseases Vol. 4, No. 1 ( 1994), p. 32-37
    Details
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 4, No. 1 ( 1994), p. 32-37
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    URL: Article
    DOI: 10.1159/000108447
    Language: English
    Publisher: S. Karger AG
    Publication Date: 1994
    detail.hit.zdb_id: 1482069-9
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  • 5
    Online Resource
    Online Resource
    Auditory Sensory Gating in the Neonatal Ventral Hippocampal Lesion Model of Schizophrenia
    S. Karger AG ; 2009
    In:  Neuropsychobiology Vol. 60, No. 1 ( 2009), p. 12-22
    Details
    In: Neuropsychobiology, S. Karger AG, Vol. 60, No. 1 ( 2009), p. 12-22
    Abstract: 〈 i 〉 Background/Aims: 〈 /i 〉 The neonatal ventral hippocampal lesion (NVHL) rat model shows biological and behavioral abnormalities similar to schizophrenia. Disturbed sensory gating reflects a consistent neurobiological abnormality in schizophrenia. Although of critical interest, sensory gating has not been evaluated in the NVHL model. 〈 i 〉 Methods: 〈 /i 〉 The N40 rat analog of the human P50 was measured to assess sensory response and gating in NVHL and sham rats. Epidural electrodes recorded evoked potentials (EPs), from which amplitudes, latencies, difference scores (S1–S2) and gating ratios (S2/S1) were assessed. Power and phase locking were computed for evoked EEG activity, to test for frequency-specific abnormalities. 〈 i 〉 Results: 〈 /i 〉 Prolonged S1 N40 latency was detected in the NVHL group, but amplitude and power measures did not differ. NVHL rats demonstrated disturbed phase-locked sensory gating at theta and beta frequencies, as well as reduced phase-locked gamma activity across stimuli, most robustly at S1. 〈 i 〉 Conclusions: 〈 /i 〉 While measures of sensory gating obtained from the EP were relatively insensitive to the NVHL model, phase locking across trials was affected. NVHL rats may have increased evoked response temporal variability, similar to patients with schizophrenia. This pattern of findings likely reflects core developmental NVHL disturbances in dorsal hippocampal circuits associated with temporal and frontal areas.
    Type of Medium: Online Resource
    ISSN: 0302-282X , 1423-0224
    URL: Article
    DOI: 10.1159/000234813
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2009
    detail.hit.zdb_id: 1483094-2
    SSG: 5,2
    SSG: 15,3
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