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F192. The relationship between cerebral artery stenosis and cerebral artery convulsion with hemorheology and hemodynamics
Vol. 32, Nos. 2-3
Free Communications
331
F192. T H E R R I A T I O N S H I P BETWEEN CERERRAL ARTERY S T E N O S I S A N D CERERRAL ARTERY C O N V U L S I O N W I T H HEMORHEOLOGY AND HEMODYNAMICS W. SHEN AND H.-F. YU Clinical Hemorheology Laboratory, Yang-pu Centre Hospital, Shanghai 200090, P. R. China To separate in diagnosis cerebral artery stenosis (CAS) and cerebral artery convulsion (CAC), various hemorheological parameters (HP) including whole blood viscosity u n d e r different shear rates, the levels of fibrinogen and cholesterol (CH), and platelet aggregation (PAG), were measured in 35 patients with CAS and 28 cases of CAC and 30 normal subjects. The blood flow velocity in the midcerebral artery (Vmca) was measured by transcranial doppler (TCD). The results show that: (1) CAS and CAC both have higher Vmca than normal subjects (p<0.01); (2) HP of the patients with CAS are higher than CAC, and the control groups (p<0.01-0.05): (3) there is no significant difference between CAC and normal subjects in HP (p>0.05); (4) in the patients with CAS, the high blood viscosity (230 s'l), and the level of CH and PAG were all increased, and correlated with Vmca (r=0.52; r=0.54; r=0.63; p<0.01-0.05). We conclude that the examination of hemorheology, combined with TCD, is a new useful method for distinguishing CAS and CAC. Also, we proved that when some HP were increased, there is an effect in the cerebral artery.
F193. MICROHEMORHEOLOGICAL P R O G N O S I S IN A C U T E STROKE
DETERMINANTS
OF
R. SHAKARISHVILI P. Sarajishvili Institute of Neurology, 380092 Tbilisi, Republic of Georgia Recent studies show that blood rheological disorders in the cerebral microcirculation play a leading role among pathogenic factors determining development of stroke, since ultimately they estimate the vital capacity of ischemic tissue. We investigated 78 patients aged 38-83. In addition to quantification of clinical signs, transcranial dopplerography, CT- and MR-tomography, and selective angiography, the following hemorheological parameters were repeatedly investigated in the course of the initial 10 days of disease: erythrocyte aggregability (with the Georgian technique), hematocrit a n d blood plasma fibrinogen. The results o b t a i n e d proved that microcirculatory stases exhibited by high RBC aggregability (the index was especially high in small-sized lacunar infarcts produced by the stases), are mostly related to hemorheological disorders leading to development of stroke. In particular, in cases of malignant course of stroke, the aggregability index demonstrated maximum values without a tendency to decrease until the 8thtenth day, the same was true of patients who exhibited repeated brain infarcts or transitory ischemic attacks. In contrast, in cases with beneficial course of stroke there was a significant, -30% lower aggregability index from the first days
Free Communications
331
F192. T H E R R I A T I O N S H I P BETWEEN CERERRAL ARTERY S T E N O S I S A N D CERERRAL ARTERY C O N V U L S I O N W I T H HEMORHEOLOGY AND HEMODYNAMICS W. SHEN AND H.-F. YU Clinical Hemorheology Laboratory, Yang-pu Centre Hospital, Shanghai 200090, P. R. China To separate in diagnosis cerebral artery stenosis (CAS) and cerebral artery convulsion (CAC), various hemorheological parameters (HP) including whole blood viscosity u n d e r different shear rates, the levels of fibrinogen and cholesterol (CH), and platelet aggregation (PAG), were measured in 35 patients with CAS and 28 cases of CAC and 30 normal subjects. The blood flow velocity in the midcerebral artery (Vmca) was measured by transcranial doppler (TCD). The results show that: (1) CAS and CAC both have higher Vmca than normal subjects (p<0.01); (2) HP of the patients with CAS are higher than CAC, and the control groups (p<0.01-0.05): (3) there is no significant difference between CAC and normal subjects in HP (p>0.05); (4) in the patients with CAS, the high blood viscosity (230 s'l), and the level of CH and PAG were all increased, and correlated with Vmca (r=0.52; r=0.54; r=0.63; p<0.01-0.05). We conclude that the examination of hemorheology, combined with TCD, is a new useful method for distinguishing CAS and CAC. Also, we proved that when some HP were increased, there is an effect in the cerebral artery.
F193. MICROHEMORHEOLOGICAL P R O G N O S I S IN A C U T E STROKE
DETERMINANTS
OF
R. SHAKARISHVILI P. Sarajishvili Institute of Neurology, 380092 Tbilisi, Republic of Georgia Recent studies show that blood rheological disorders in the cerebral microcirculation play a leading role among pathogenic factors determining development of stroke, since ultimately they estimate the vital capacity of ischemic tissue. We investigated 78 patients aged 38-83. In addition to quantification of clinical signs, transcranial dopplerography, CT- and MR-tomography, and selective angiography, the following hemorheological parameters were repeatedly investigated in the course of the initial 10 days of disease: erythrocyte aggregability (with the Georgian technique), hematocrit a n d blood plasma fibrinogen. The results o b t a i n e d proved that microcirculatory stases exhibited by high RBC aggregability (the index was especially high in small-sized lacunar infarcts produced by the stases), are mostly related to hemorheological disorders leading to development of stroke. In particular, in cases of malignant course of stroke, the aggregability index demonstrated maximum values without a tendency to decrease until the 8thtenth day, the same was true of patients who exhibited repeated brain infarcts or transitory ischemic attacks. In contrast, in cases with beneficial course of stroke there was a significant, -30% lower aggregability index from the first days