- Email: [email protected]
4-07-21 Behavior of the risk factors to vascular dementia in a group of patients with cerebrovascular diseases
Cerebrovascular
S218 4 07 18 I__/
Diseases
Do stroke patients understand the role of hypertension in their disease?
(l/11/1993-31/12/1996). We considered MAC a band of dense high-intensity echoes between mitral valve and the posterior left ventricular wall. All stroke patients were studied including at least one CT-scan or MRI. We analysed the association of MAC with non-rheumatic atrial fibrilation (NRAF), other arrythmias, other cardiac calcifications, mitral valve prolapse, other valvular heart disease, left ventricular hypertrophy (LVH), large left atrium and ischemic cardiopathy, using logistic regression analysis. From 386 patients, median age was 67 and 173 were male. Results: MAC was present in 139 patients (36%) and recent ischemic stroke (less than 8 days) in 87 (22.5%). NRAF was present in 35 (9.1%), ischemic heart disease 32, LVH 29 and large left atrium 56. MAC was related with no one except LVH (p = 0.045: Odds Ratio: 2.43,95% Confidence Interval: 1.02-6.57) and large left atrium (p = 0.001; OR: 3.37, 95% Cl: 1.63-6.96). Conclusion: The increased risk for ischemic stroke in patients with MAC does not seem to be explained by the co-presence of other cardioembolic sources. MAC related with LVH and large left atrium, so, the relationship between ischemic stroke, hypertension and MAC deserves further research.
L. Hale, V. Fritz ’ ‘Department of Neurology University of the Witwatersrand, Johannesburg, South Africa, Department of Physiotherapy, University of the Witwatersrand, Johannesburg, South Africa Aims: (1) To assess the importance of hypertension in a group of black stroke patients. (2) To evaluate the patient’s insight into the role hypertension has played in causing their stroke. (3) To find out if patients know what medication they are using and what it is for. Methods: All patients between 30 and 75 years of age with a first ever stroke in the middle cerebral altery territory admitted to the medical admissions ward at Baragwanath Hospital, Johannesburg over a 3 month period (5-2-1996 to 29-6-1996) were selected. Patients were only included in the study following a successful follow-up visit to their own home 12-14 weeks after discharge. Results: A total of 361 stroke patients were initially screened. Only 54 fulfilled all inclusion criteria, 38 (70%) over 50 years of age and 16 (30%) under 50 years. 93 of the 361 died within the first 3 months. 71% of all the patients knew that they had suffered a stroke. Only 20% of the total group understood that hypertension had probably caused the stroke although 76% of the older age group and 56% of the younger age group had been told at some stage that they were hypertensive. 32% of the older group knew the name of their medication, 21% knew they were hypertensive on therapy but could not name their drug, 23% were hypertensive but claimed they were on no therapy and 24% were not hypertensive. Similarly in the younger group, 19% could name their medication, 25%could not name their medication, 12% were hypertensive on no therapy and 44% were not hypertensive. Conclusions: Most black stroke patients in this study appear well aware of their hypertension and do attend clinics or doctors. However many seem unaware that their hypertension and stroke are causally linked and their therapeutic knowledge is suboptimal. An awareness campaign to link hypertension and stroke in the public eye in South Africa is required.
4-07-l 9
E - selectin appears in non-ischemic tissue during experimental focal cerebral ischemia
H.-P. Haring’, E. Berg3, N. Tsurushita3, M. Tagaya’, G.J.D. Zoppo’. ’ Department of Neurology; Univ. of Innsbruck, Austria, 2 Department of Molecular and Experimental Medicine, The Scripps Research Instifute, La Jo//a, CA, USA, 3Protein Design Labs, Inc., CA, USA Background and Purpose: E - selectin is a key player in PMN leucocyte - endothelial adhesion and the inflammatory process following focal cerebral ischemia and reperfusion. This study was undertaken to evaluate the temporal and topographical pattern of microvascular E - selectin expression following experimental focal cerebral ischemia and reperfusion. Methods: The upregulation and fate of E - selectin antigen during middle cerebral artery occlusion (2 hour; n = 2) and occlusion (3 hour) with reperfusion (1 hour, n = 2; 4 hour, n = 3; 24 hour, n = 3) was evaluated in the non-human primate. Using computerized light microscopy video imaging and laser confccal microscopy, E - selectin and E/P - selectin immunoreactivities were semiquantitatively analysed. Results: Two patterns of E - selectin expression were found. Low chromogen intensity was observed at 2 hour occlusion extending to 4 hour reperfusion in the ischemic tissue. At 24 hour reperfusion, a significant increase in microvessels with high chromogen display (p < 0.008) occurred in the ischemic tissue. Also, low chromogen signal appeared in the non-ischemic basal ganglia at 24 hour reperfusion, as confirmed by blockade of the anti E - selectin antibody with recombinant human E - selectin, and by use of an E/P - selectin immunoprobe. Conclusions: E-Selectin is significantly upregulated in non human primate brain following focal ischemia and reperfusion. The appearance of E selectin in non-ischemic cerebral tissues late following ischemia and reperfusion suggests that its expression outside the ischemic zone is stimulated by transferrable factors.
4 07 20
1__1
Mitral annular and ischemic stroke: Cardioembolic source or marker for atherosclerosis?
I.L. Henriques, J. Correia’, A.L. Leitlo. Neurology Espfrito Santa, gvora, Portugal, ’ Internal Medicine Espiriro Sanro, f%ora, Portugal
Deparfment Department
Hospital Hospital
Introduction: Mitral annular calcification (MAC) is associated with an increased risk for ischemic stroke. MAC is considered a minor source of cardioembolism but the arguments favouring cardioembolism are not clearly established. We analysed the possible association between MAC and other concomitant cardioembolic sources. Material and Methods: We prospectively included all patients that were consecutively submitted to transthoracic echocardiography in our department
4-07-21
Behavior of the risk factors to vascular dementia in a group of patients with cerebrovascular diseases
E. HernBndez, A. Fernindez, J. Sdnchez, F. Zamora, I. Castaiieda. lnternacional Center of Neurological Restoration, Havana City; Cuba The symptomatic cerebral vascular diseases (CVD) increase the risk of dementia in more than nine times which probably constitutes the second cause. We evaluated the behavior of risk associated factors with augmented vascular risk of dementia in a group of patients with ischemic and hemorrhagic cerebrovascular disease. Sixteen patients were studied from 46 to 78 years that were on the acute, sub-acute and chronic phase of itius. The increase in age, the antecedent of high blood pressure, the lesion of white matter, the presence of cerebral atrophy, cortical strokes and CVD in the left hemisphere were the ones related to whit greater cognitive deterioration, as related to the neuro-psychological evaluation. In four patients (25%) according to the DRS test for dementia, they presented light or moderate dementia, when we applied the Hachinski’scale, they presented the greatest indexes for vascular demencia. The antecedent of diabetes mellitus and heart attack was present only in two patients (12.5%), that makes us doubt whether the risk factors for vascular dementia differed from those found in the CVD. Others factors as early urinary incontinence, under educational level, antecedent of craneal traumatism, did not have a significative behavior in the group under study.
I
4-07-22
Weekly trends in stroke as a cause of adult sudden death
Yutaka Hirata, Mika Sato, Ken Nagata. Vessels, Akita, Japan
Research
institute
for Brain andBlood
Objective: This study was designed to elucidate weekly trends in adult sudden death (intrinsic death) due to cerebrovascular disease (stroke) within 24 hours of onset. Subjects and Methods: One hundred and seventy-five adults (117 men, 58 women), victims of sudden death caused by stroke (97 brain hemorrhage (BH), 69 subarachnoid hemorrhage (SAH),S brain infarction) in past 17 years were studied. Weekly number of stroke victims was analyzed. Results: The number of victims of sudden death caused by stroke was as follows; 28 cases on Monday, 23 on Tuesday, 28 on Wednesday, 33 on Thursday, 21 on Friday, 22 on Saturday, and 17 on Sunday. On Thursday victims were most frequent, and on Sunday the least, but the difference was not significant. These tendency was similar for SAH (Thursday 21.7%, on Monday 5.8%), and the frequency was almost even for BH victims. As for the age, elderly patients older than 65 years showed similar tendency as SAH victims. There was a strong male preponderance on Mondays (male 25, female 3, p < 0.05), 20 male victims (80%) being younger than 85 years, and 75% of them suffered stroke during work. Conclusion: The results suggest that male preponderance on Mondays may have relationship to stressful situation during work that may be amenable to preventive strategies.
4-07-23
Anticardiolipin antibodies and stroke: Data from the Italian longitudinal study on aging (ILSA)
Domenico lnzitari ‘, Paola Vanni I, Giuseppe Ermini 2, Giampiero Ciampi 2, August0 Ghetti ‘. ’ Department of Neurological Science, University of Florence, 2 Santa Maria Annunziafa Hospital, Health Area IO, Florence, /fa/y The association of anticardiolipin antibodies (ACAs) with stroke is still controversial. We tested for ACAs via IgG or IgM the sera of 435 (227 M and 208 F; mean age 74.45 f 5.74) out of 698 random cohort subjects, participating
S218 4 07 18 I__/
Diseases
Do stroke patients understand the role of hypertension in their disease?
(l/11/1993-31/12/1996). We considered MAC a band of dense high-intensity echoes between mitral valve and the posterior left ventricular wall. All stroke patients were studied including at least one CT-scan or MRI. We analysed the association of MAC with non-rheumatic atrial fibrilation (NRAF), other arrythmias, other cardiac calcifications, mitral valve prolapse, other valvular heart disease, left ventricular hypertrophy (LVH), large left atrium and ischemic cardiopathy, using logistic regression analysis. From 386 patients, median age was 67 and 173 were male. Results: MAC was present in 139 patients (36%) and recent ischemic stroke (less than 8 days) in 87 (22.5%). NRAF was present in 35 (9.1%), ischemic heart disease 32, LVH 29 and large left atrium 56. MAC was related with no one except LVH (p = 0.045: Odds Ratio: 2.43,95% Confidence Interval: 1.02-6.57) and large left atrium (p = 0.001; OR: 3.37, 95% Cl: 1.63-6.96). Conclusion: The increased risk for ischemic stroke in patients with MAC does not seem to be explained by the co-presence of other cardioembolic sources. MAC related with LVH and large left atrium, so, the relationship between ischemic stroke, hypertension and MAC deserves further research.
L. Hale, V. Fritz ’ ‘Department of Neurology University of the Witwatersrand, Johannesburg, South Africa, Department of Physiotherapy, University of the Witwatersrand, Johannesburg, South Africa Aims: (1) To assess the importance of hypertension in a group of black stroke patients. (2) To evaluate the patient’s insight into the role hypertension has played in causing their stroke. (3) To find out if patients know what medication they are using and what it is for. Methods: All patients between 30 and 75 years of age with a first ever stroke in the middle cerebral altery territory admitted to the medical admissions ward at Baragwanath Hospital, Johannesburg over a 3 month period (5-2-1996 to 29-6-1996) were selected. Patients were only included in the study following a successful follow-up visit to their own home 12-14 weeks after discharge. Results: A total of 361 stroke patients were initially screened. Only 54 fulfilled all inclusion criteria, 38 (70%) over 50 years of age and 16 (30%) under 50 years. 93 of the 361 died within the first 3 months. 71% of all the patients knew that they had suffered a stroke. Only 20% of the total group understood that hypertension had probably caused the stroke although 76% of the older age group and 56% of the younger age group had been told at some stage that they were hypertensive. 32% of the older group knew the name of their medication, 21% knew they were hypertensive on therapy but could not name their drug, 23% were hypertensive but claimed they were on no therapy and 24% were not hypertensive. Similarly in the younger group, 19% could name their medication, 25%could not name their medication, 12% were hypertensive on no therapy and 44% were not hypertensive. Conclusions: Most black stroke patients in this study appear well aware of their hypertension and do attend clinics or doctors. However many seem unaware that their hypertension and stroke are causally linked and their therapeutic knowledge is suboptimal. An awareness campaign to link hypertension and stroke in the public eye in South Africa is required.
4-07-l 9
E - selectin appears in non-ischemic tissue during experimental focal cerebral ischemia
H.-P. Haring’, E. Berg3, N. Tsurushita3, M. Tagaya’, G.J.D. Zoppo’. ’ Department of Neurology; Univ. of Innsbruck, Austria, 2 Department of Molecular and Experimental Medicine, The Scripps Research Instifute, La Jo//a, CA, USA, 3Protein Design Labs, Inc., CA, USA Background and Purpose: E - selectin is a key player in PMN leucocyte - endothelial adhesion and the inflammatory process following focal cerebral ischemia and reperfusion. This study was undertaken to evaluate the temporal and topographical pattern of microvascular E - selectin expression following experimental focal cerebral ischemia and reperfusion. Methods: The upregulation and fate of E - selectin antigen during middle cerebral artery occlusion (2 hour; n = 2) and occlusion (3 hour) with reperfusion (1 hour, n = 2; 4 hour, n = 3; 24 hour, n = 3) was evaluated in the non-human primate. Using computerized light microscopy video imaging and laser confccal microscopy, E - selectin and E/P - selectin immunoreactivities were semiquantitatively analysed. Results: Two patterns of E - selectin expression were found. Low chromogen intensity was observed at 2 hour occlusion extending to 4 hour reperfusion in the ischemic tissue. At 24 hour reperfusion, a significant increase in microvessels with high chromogen display (p < 0.008) occurred in the ischemic tissue. Also, low chromogen signal appeared in the non-ischemic basal ganglia at 24 hour reperfusion, as confirmed by blockade of the anti E - selectin antibody with recombinant human E - selectin, and by use of an E/P - selectin immunoprobe. Conclusions: E-Selectin is significantly upregulated in non human primate brain following focal ischemia and reperfusion. The appearance of E selectin in non-ischemic cerebral tissues late following ischemia and reperfusion suggests that its expression outside the ischemic zone is stimulated by transferrable factors.
4 07 20
1__1
Mitral annular and ischemic stroke: Cardioembolic source or marker for atherosclerosis?
I.L. Henriques, J. Correia’, A.L. Leitlo. Neurology Espfrito Santa, gvora, Portugal, ’ Internal Medicine Espiriro Sanro, f%ora, Portugal
Deparfment Department
Hospital Hospital
Introduction: Mitral annular calcification (MAC) is associated with an increased risk for ischemic stroke. MAC is considered a minor source of cardioembolism but the arguments favouring cardioembolism are not clearly established. We analysed the possible association between MAC and other concomitant cardioembolic sources. Material and Methods: We prospectively included all patients that were consecutively submitted to transthoracic echocardiography in our department
4-07-21
Behavior of the risk factors to vascular dementia in a group of patients with cerebrovascular diseases
E. HernBndez, A. Fernindez, J. Sdnchez, F. Zamora, I. Castaiieda. lnternacional Center of Neurological Restoration, Havana City; Cuba The symptomatic cerebral vascular diseases (CVD) increase the risk of dementia in more than nine times which probably constitutes the second cause. We evaluated the behavior of risk associated factors with augmented vascular risk of dementia in a group of patients with ischemic and hemorrhagic cerebrovascular disease. Sixteen patients were studied from 46 to 78 years that were on the acute, sub-acute and chronic phase of itius. The increase in age, the antecedent of high blood pressure, the lesion of white matter, the presence of cerebral atrophy, cortical strokes and CVD in the left hemisphere were the ones related to whit greater cognitive deterioration, as related to the neuro-psychological evaluation. In four patients (25%) according to the DRS test for dementia, they presented light or moderate dementia, when we applied the Hachinski’scale, they presented the greatest indexes for vascular demencia. The antecedent of diabetes mellitus and heart attack was present only in two patients (12.5%), that makes us doubt whether the risk factors for vascular dementia differed from those found in the CVD. Others factors as early urinary incontinence, under educational level, antecedent of craneal traumatism, did not have a significative behavior in the group under study.
I
4-07-22
Weekly trends in stroke as a cause of adult sudden death
Yutaka Hirata, Mika Sato, Ken Nagata. Vessels, Akita, Japan
Research
institute
for Brain andBlood
Objective: This study was designed to elucidate weekly trends in adult sudden death (intrinsic death) due to cerebrovascular disease (stroke) within 24 hours of onset. Subjects and Methods: One hundred and seventy-five adults (117 men, 58 women), victims of sudden death caused by stroke (97 brain hemorrhage (BH), 69 subarachnoid hemorrhage (SAH),S brain infarction) in past 17 years were studied. Weekly number of stroke victims was analyzed. Results: The number of victims of sudden death caused by stroke was as follows; 28 cases on Monday, 23 on Tuesday, 28 on Wednesday, 33 on Thursday, 21 on Friday, 22 on Saturday, and 17 on Sunday. On Thursday victims were most frequent, and on Sunday the least, but the difference was not significant. These tendency was similar for SAH (Thursday 21.7%, on Monday 5.8%), and the frequency was almost even for BH victims. As for the age, elderly patients older than 65 years showed similar tendency as SAH victims. There was a strong male preponderance on Mondays (male 25, female 3, p < 0.05), 20 male victims (80%) being younger than 85 years, and 75% of them suffered stroke during work. Conclusion: The results suggest that male preponderance on Mondays may have relationship to stressful situation during work that may be amenable to preventive strategies.
4-07-23
Anticardiolipin antibodies and stroke: Data from the Italian longitudinal study on aging (ILSA)
Domenico lnzitari ‘, Paola Vanni I, Giuseppe Ermini 2, Giampiero Ciampi 2, August0 Ghetti ‘. ’ Department of Neurological Science, University of Florence, 2 Santa Maria Annunziafa Hospital, Health Area IO, Florence, /fa/y The association of anticardiolipin antibodies (ACAs) with stroke is still controversial. We tested for ACAs via IgG or IgM the sera of 435 (227 M and 208 F; mean age 74.45 f 5.74) out of 698 random cohort subjects, participating