Speciality
Spotlight

 




 


Neurology


 

 




Cerebrovascular
Disease


     

  • M Goertler, M Baeumer et al (Univ. of Magdeburg, Germany)

    Rapid Decline of Cerebral Microemboli of Arterial Origin after Intravenous Acetyl Salicylic Acid.

    Stroke 30; 66-99, 1999.

       

    In patients with carotid artery stenosis, the transcranial Doppler (TCD) sonographic finding of microembolic signals (MES) reflects platelet and fibrin particles coming from the stenotic lesions.



    The effect of IV Acetylsalicylic acid (ASA) treatment on the occurrence of cerebral MES was assessed on 9 patients with a history of transient ischaemic attacks (TIAs) or minor stroke referable to the territory of the middle cerebral artery.



    ASA reduces cerebral embolism by means of cyclo-oxygenase pathway-related platelet inhibition.



    It was found that IV ASA significantly reduces the MES rate in patients with recent arterial stroke. Monitoring of microembolism with TCD might be a useful indicator of the early effects of antiplatelet therapy.

         

      
  • M D Ezekowitz, JA Levine, (Yale Univ, New Haven, Conn; Veterans Affairs Med Ctr, West Haven, Conn)

    Preventing Stroke in Patients with Atrial Fibrillation

    JAMA 281: 1830-1835, 1999

      

    Protection offered by warfarin is most pronounced in patients at highest risk for strokes. For patients at low risk, aspirin seems to be adequate.

      

      
  • T G Kwiatkowski, (Long Island Jewish Med Ctr, New Hyde Park, NY; et al.

    Effects of Tissue Plasminogen Activator for Acute Ischemic Stroke at One Year.

    N Engl J Med. 340: 1781-1787, 1999

      

    Patients treated with tissue plasminogen activator (t-PA) within 3 hours after symptom onset of an acute ischaemic stroke were about 30% more likely to have minimal or no disability at 3 months after the stroke compared with patients who received placebo. Mortality at 3 months was similar for both groups.



    There was no disability 12 months, after treatment with T-PA (compared with patients treated with placebo).

       

      
  • RG Hart, O Benavente, et al (Univ. of Texas, San Antonio; Axio Research Corp, Seattle) 

    Antithrombotic Therapy to Prevent Stroke in Patients with Atrial Fibrillation: A Meta-analysis.

    Ann Intern Med 131: 492-501, 1999

       

    Sixteen randomized trials published between 1989 and 1999 were included, including 9874 participants with nonvalvular atrial fibrillation, followed up for an average of 1.7 years.



    Out of these 2239 received placebo and the rest were treated. Adjusted dose warfarin reduced stroke by 62%. Major extracranial bleeding was increased by warfarin therapy, with a 0.3% per year absolute risk increase/



    Aspirin reduced stroke by 22%.

    Adjusted dose warfarin was more effective than aspirin.



    The increased risk of haemorrhage (due to therapy) does not offset the benefit of stroke reductions.

       

       
  • H Iso, CH Hennekens, et al (Harvard Med School, Boston)

    Prospective Study of Aspirin Use and Risk of Stroke in Women

    Stroke 30: 1764-1771, 1999

        

    This study of 79,319 female nurses (age 34-59 yrs) over a period of 14 years from 1980 to 1994, assessed the relationship between aspirin use and stroke.



    Women taking 1 to 6 aspirin per week are at reduced risk of large-artery occlusive infarction, whereas those taking 15 or more aspirin per week are at increased risk of subarachnoid haemorrhage

        

  • A
    Ascherio, EB Rimm, MA Hernan, et al (Harvard School of Public Health, Boston; Harvard Med School, Boston; Brigham and Women’s
    Hosp, Boston)

    Relation of Consumption of Vitamin E, Vitamin C and
    Carotenoids to Risk for Stroke Among Men in the United
    States.


    Ann Intern Med 130: 963-970, 1999

      

    Data from Health Professionals Follow-up Study were used to assess the relationship between intake of vitamin E, vitamin C, carotenoids and the risk of ischaemic stroke (51529 men between ages of 40-75 yrs).



    This prospective analysis finds no significant effect of vitamin E or C administration, on total or ischaemic stroke risk.



    Dietary advice to reduce stroke risk should emphasize increased intake of fruits and vegetables rather than vitamin supplements.





       



 



 

 

Speciality Spotlight

 

 
Neurology
 

 

Cerebrovascular Disease
     

  • M Goertler, M Baeumer et al (Univ. of Magdeburg, Germany)
    Rapid Decline of Cerebral Microemboli of Arterial Origin after Intravenous Acetyl Salicylic Acid.
    Stroke 30; 66-99, 1999.
       
    In patients with carotid artery stenosis, the transcranial Doppler (TCD) sonographic finding of microembolic signals (MES) reflects platelet and fibrin particles coming from the stenotic lesions.

    The effect of IV Acetylsalicylic acid (ASA) treatment on the occurrence of cerebral MES was assessed on 9 patients with a history of transient ischaemic attacks (TIAs) or minor stroke referable to the territory of the middle cerebral artery.

    ASA reduces cerebral embolism by means of cyclo-oxygenase pathway-related platelet inhibition.

    It was found that IV ASA significantly reduces the MES rate in patients with recent arterial stroke. Monitoring of microembolism with TCD might be a useful indicator of the early effects of antiplatelet therapy.
         
      
  • M D Ezekowitz, JA Levine, (Yale Univ, New Haven, Conn; Veterans Affairs Med Ctr, West Haven, Conn)
    Preventing Stroke in Patients with Atrial Fibrillation
    JAMA 281: 1830-1835, 1999
      
    Protection offered by warfarin is most pronounced in patients at highest risk for strokes. For patients at low risk, aspirin seems to be adequate.
      
      
  • T G Kwiatkowski, (Long Island Jewish Med Ctr, New Hyde Park, NY; et al.
    Effects of Tissue Plasminogen Activator for Acute Ischemic Stroke at One Year.
    N Engl J Med. 340: 1781-1787, 1999
      
    Patients treated with tissue plasminogen activator (t-PA) within 3 hours after symptom onset of an acute ischaemic stroke were about 30% more likely to have minimal or no disability at 3 months after the stroke compared with patients who received placebo. Mortality at 3 months was similar for both groups.

    There was no disability 12 months, after treatment with T-PA (compared with patients treated with placebo).
       
      
  • RG Hart, O Benavente, et al (Univ. of Texas, San Antonio; Axio Research Corp, Seattle) 
    Antithrombotic Therapy to Prevent Stroke in Patients with Atrial Fibrillation: A Meta-analysis.
    Ann Intern Med 131: 492-501, 1999
       
    Sixteen randomized trials published between 1989 and 1999 were included, including 9874 participants with nonvalvular atrial fibrillation, followed up for an average of 1.7 years.

    Out of these 2239 received placebo and the rest were treated. Adjusted dose warfarin reduced stroke by 62%. Major extracranial bleeding was increased by warfarin therapy, with a 0.3% per year absolute risk increase/

    Aspirin reduced stroke by 22%.
    Adjusted dose warfarin was more effective than aspirin.

    The increased risk of haemorrhage (due to therapy) does not offset the benefit of stroke reductions.
       
       
  • H Iso, CH Hennekens, et al (Harvard Med School, Boston)
    Prospective Study of Aspirin Use and Risk of Stroke in Women
    Stroke 30: 1764-1771, 1999
        
    This study of 79,319 female nurses (age 34-59 yrs) over a period of 14 years from 1980 to 1994, assessed the relationship between aspirin use and stroke.

    Women taking 1 to 6 aspirin per week are at reduced risk of large-artery occlusive infarction, whereas those taking 15 or more aspirin per week are at increased risk of subarachnoid haemorrhage
        
  • A Ascherio, EB Rimm, MA Hernan, et al (Harvard School of Public Health, Boston; Harvard Med School, Boston; Brigham and Women’s Hosp, Boston)
    Relation of Consumption of Vitamin E, Vitamin C and Carotenoids to Risk for Stroke Among Men in the United States.
    Ann Intern Med 130: 963-970, 1999
      
    Data from Health Professionals Follow-up Study were used to assess the relationship between intake of vitamin E, vitamin C, carotenoids and the risk of ischaemic stroke (51529 men between ages of 40-75 yrs).

    This prospective analysis finds no significant effect of vitamin E or C administration, on total or ischaemic stroke risk.

    Dietary advice to reduce stroke risk should emphasize increased intake of fruits and vegetables rather than vitamin supplements.


       

 

 

By |2022-07-20T16:41:27+00:00July 20, 2022|Uncategorized|Comments Off on Cerebrovascular Disease

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