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1.
Rev. Assoc. Med. Bras. (1992) ; 65(11): 1368-1373, Nov. 2019. tab, graf
Article in English | LILACS | ID: biblio-1057071

ABSTRACT

SUMMARY OBJECTIVE: We aimed to investigate cardiac and extra-cardiac pathologies in patients who were operated for acute arterial occlusion. METHODS: Between March 2010 and March 2018, a total of 120 patients who underwent surgical treatment for acute arterial occlusion were included in this retrospective study. RESULTS: 84 (70%) and 27 (22. 5%) of the patients had cardiac and extra-cardiac pathologies, respectively. In 9 (7. 5%) of the cases, no reason for arterial occlusion could be found. Pure atrial fibrillation was found in 39 (32. 5%) patients. Atrial fibrillation and cardiac valvular pathologies were detected in 45 patients (37. 5%). Among those with a cardiac valvular pathology, 9 patients (7. 5%) had pure mitral stenosis, 21 patients (17. 5%) had moderate to advanced mitral stenosis with tricuspid regurgitation, 9 patients (7. 5%) had 20-30 mitral regurgitation with 30 tricuspid regurgitation, 3 patients (2. 5%) had moderate mitral stenosis, 30-40 tricuspid regurgitation and 20-30 aortic stenosis, and 3 patients (2. 5%) had 30 mitral regurgitation, 10- 20 tricuspid regurgitation, calcific moderate aortic stenosis, and coronary artery disease. Among those 27 patients with an extra-cardiac pathology, 21 patients (22. 5%) had peripheral artery disease, 3 patients (2.5%) had an abdominal aortic aneurysm, and 3 patients (2. 5%) had Behçet's Disease. CONCLUSION: Cardiac and extra-cardiac pathologies should be kept in mind in patients with acute arterial occlusion. Thus, detected pathologies could be treated, and the development of additional peripheral emboli could be prevented.


RESUMO OBJETIVO: O objetivo do estudo é investigar patologias cardíacas e extracardíacas em pacientes operados por oclusão arterial aguda. MÉTODOS: Entre março de 2010 e março de 2018, um total de 120 pacientes submetidos a tratamento cirúrgico para oclusão arterial aguda foram incluídos neste estudo retrospectivo. RESULTADOS: Dos pacientes incluídos, 84 (70%) e 27 (22.5%) apresentavam, respectivamente, patologias cardíacas e extracardíacas. Em 9 (7.5%) dos casos, nenhuma cause para a oclusão arterial foi encontrada. Fibrilação atrial isolada foi encontrada em 39 (32.5%) pacientes. Fibrilação atrial e valvopatias cardíacas foram detectadas em 45 pacientes (37.5%). Entre aqueles com valvopatias cardíacas, 9 (7.5%) tinham estenose mitral isolada, 21 (17. 5%) tinham estenose mitral moderada a avançada com regurgitação tricúspide, 9 (7. 5%) tinham 2°-3° de regurgitação mitral com 3o regurgitação tricúspide, 3 (2. 5%) tinham estenose mitral moderada, 3°-4° regurgitação tricúspide e 2°-3° estenose aórtica, e 3 (2.5%) tinham 3o mitral, 1°- 2° regurgitação tricúspide moderada, estenose aórtica moderada calcificada e doença coronariana. Entre os 27 pacientes com patologia extracardíaca, 21 (22.5%) tinham doença arterial periférica, 3 (2,5%) tinham aneurisma da aorta abdominal, e 3 (2.5%) tinham Doença de Behçet. CONCLUSÃO: Patologias cardíacas e extracardíacas devem ser consideradas em pacientes com oclusão arterial aguda. Assim, patologias detectadas podem ser tratadas e o desenvolvimento de trombos periféricos adicionais pode ser evitado.


Subject(s)
Humans , Male , Female , Adult , Aged , Young Adult , Arterial Occlusive Diseases/complications , Arterial Occlusive Diseases/surgery , Arterial Occlusive Diseases/diagnostic imaging , Severity of Illness Index , Acute Disease , Retrospective Studies , Middle Aged
2.
J. vasc. bras ; 15(1): 44-51, jan.-mar. 2016.
Article in English, Portuguese | LILACS | ID: lil-780900

ABSTRACT

A desnutrição é uma doença extremamente prevalente em pacientes internados, chegando a acometer 50% deles, 47% dos pacientes cirúrgicos e entre 39 e 73% dos portadores de doença arterial periférica, com grande impacto na morbimortalidade desses pacientes. A desnutrição possui grande relevância no desfecho clínico desses pacientes durante a internação, estando associada a maior incidência de infecções, demora na cicatrização das feridas, diminuição do status de deambulação, maior tempo de internação e mortalidade. Entretanto, o diagnóstico de desnutrição ou risco nutricional desses pacientes tem sido um desafio. A avaliação nutricional subjetiva global revelou-se, até o momento, o padrão ouro como método de triagem de pacientes cirúrgicos internados devido à sua praticidade e acurácia. O objetivo deste trabalho é revisar métodos utilizados na avaliação do estado nutricional e da triagem nutricional de pacientes internados e caracterizar a importância dessa avaliação nos desfechos clínicos dos pacientes com arteriopatias.


Malnutrition is an extremely common disease among hospitalized patients, with prevalence rates as high as 50% overall, 47% among surgical patients and from 39 to 73% among patients with peripheral arterial disease. It has a major impact on morbidity and mortality among these patients. Malnutrition is very relevant to these patients’ clinical outcomes and is associated with a higher incidence of infections, slower wound healing, lower rates of mobility, longer hospital stays and greater mortality. However, diagnosing malnutrition or nutritional risk in these patients has proven to be a challenge. To date, subjective global nutritional assessment remains the gold standard screening method for use with hospitalized surgical patients because of its practicality and accuracy. The objective of this study is to review methods used for assessment of nutritional status and for nutritional screening of hospitalized patients and determine the importance of these assessments to the clinical outcomes of patients with arteriopathies.


Subject(s)
Humans , Nutrition Assessment , Infection Control , Peripheral Arterial Disease/diet therapy , Peripheral Arterial Disease/mortality , Peripheral Arterial Disease/rehabilitation , Inpatients/history , Arterial Occlusive Diseases/complications , Wound Healing , Incidence , Triage/methods , Length of Stay
3.
Rev. Assoc. Med. Bras. (1992) ; 59(6): 557-562, nov.-dez. 2013. tab
Article in Portuguese | LILACS | ID: lil-697385

ABSTRACT

RESUMO OBJETIVO: Comparar características angiográficas de pacientes diabéticos e não diabéticos com isquemia crítica. MÉTODOS: Foram incluídos 161 membros inferiores de pacientes com isquemia crítica infrainguinal. Avaliaram-se as características clínicas e arteriográficas (número e presença de opacificação das artérias da perna) dos dois grupos de pacientes. A análise estatística foi realizada pelo EPI-INFO RESULTADOS: A maioria dos pacientes era categoria 5da Classificação de Rutherford e apresentava doença do território fêmoro-poplíteo. Opacificação da artéria fibular foi encontrada em 72% dos não diabéticos e em 67% dos diabéticos (p = 0,25), sendo esta a artéria mais presente em ambos os grupos. Os diabéticos apresentaram menor índice de opacificação da artéria tibial posterior na análise univariada (29% vs. 47%; p = 0,008). Na regressão logística, apenas o sexo feminino se mostrou significante para a ausência da artéria tibial posterior (OR = 2,6; p = 0,01) CONCLUSÃO: A artéria fibular foi a mais encontrada nas angiografias de diabéticos e não diabéticos com isquemia crítica. Diabéticos e não diabéticos não diferiram em relação ao padrão angiográfico da perna.


OBJECTIVE: To compare angiographic findings of diabetic and non-diabetic patients with critical limb ischemia. METHODS: We included 161 patients with infrainguinal critical limb ischemia (CLI). We evaluated the clinical and arteriographic (number and presence of opacification of leg arteries) of the two groups of patients. Statistical analysis was performed using EPI-INFO. RESULTS: Most patientswere category 5 of Rutherford's Classification and had femoropopliteal disease. Seventy-two percent of non-diabetic and 67% of diabetic had opacification of the fibular artery (p = 0.25), this is the most present artery in both groups. Diabetic patients had less opacification of the posterior tibial artery in the univariate analysis (29% vs. 47%, p = 0.008). But only female sex showed a significant risk for the absence of the posterior tibial artery in logistic regression (OR = 2.6; p = 0.01). CONCLUSION: The peroneal artery was the most frequently artery in angiograms of diabetic and non-diabetic patients with CLI. Diabetic and non-diabetic patients did not differ in angiographic findings of the leg.


Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Arterial Occlusive Diseases , Diabetic Angiopathies , Ischemia , Lower Extremity/blood supply , Peripheral Arterial Disease , Angiography, Digital Subtraction/standards , Arterial Occlusive Diseases/complications , Diabetes Complications , Inguinal Canal , Leg/blood supply , Medical Records , Peripheral Arterial Disease/etiology , Risk Factors
4.
Article in English | WPRIM | ID: wpr-44592

ABSTRACT

We report a case of erectile dysfunction caused by external iliac artery occlusion, associated with pelvic steal syndrome; bilateral internal iliac arteries were patent. The patient stated that he had experienced erectile dysfunction at similar times along with claudication, but he did not mention it before angiography. He expressed that the erectile dysfunction did not last long and that he felt completely okay after the interventional procedure, in addition to his claudication. Successful treatment of the occlusion, by percutaneous transluminal angioplasty and stent implantation, helped resolve erectile dysfunction completely and treat the steal syndrome.


Subject(s)
Angioplasty , Arterial Occlusive Diseases/complications , Erectile Dysfunction/etiology , Humans , Iliac Artery/pathology , Intermittent Claudication/complications , Male , Middle Aged , Stents , Subclavian Steal Syndrome/complications
6.
Arq. neuropsiquiatr ; 70(8): 609-616, Aug. 2012. ilus, tab
Article in English | LILACS | ID: lil-645373

ABSTRACT

OBJECTIVE: To evaluate the neuroprotection of mild hypothermia, applied in different moments, in temporary focal cerebral ischemia in rats. METHODS: Rats was divided into Control (C), Sham (S), Ischemic-control(IC), Pre-ischemic Hypothermia (IH1), Intra-ischemic Hypothermia (IH2), and Post-ischemic Hypothermia (IH3) groups. Morphometry was performed using the KS400 software (Carl Zeiss®) in coronal sections stained by Luxol Fast Blue. Ischemic areas and volumes were obtained. RESULTS: Statistically, blue areas showed difference for C vs. IC, IC vs. IH1 and IC vs. IH2 (p=0.0001; p=0.01; p=0.03), and no difference between C vs. S, IC vs. IH3 and IH vs. IH2 (p=0.39; p=0.85; p=0.63). Red areas showed difference between C vs. IC, IC vs. IH1 and IC vs. IH2 (p=0.0001; p=0.009; p=0.03), and no difference between C vs. S, IC vs. IH3 and IH1 vs. IH2 (p=0.48; p=0.27; p=0.68). Average ischemic areas and ischemic volumes showed difference between IC vs. IH1 and IC vs. IH2 (p=0.0001 and p=0.0011), and no difference between IC vs. IH3 and IH1 vs. IH2 (p=0.57; p=0.79). CONCLUSION: Pre-ischemic and intra-ischemic hypothermia were shown to be similarly neuroprotective, but this was not true for post-ischemic hypothermia.


OBJETIVO: Avaliar a neuroproteção da hipotermia leve, aplicada em diferentes momentos, durante isquemia cerebral focal temporária em ratos. MÉTODOS: Ratos foram divididos em grupos: Controle (C), Sham (S), Controle-isquêmico (IC), Hipotermia Pré-isquêmica (IH1), Hipotermia Intra-isquêmica (IH2) e Hipotermia Pós-isquêmica (IH3). A morfometria foi realizada em secções coronais coradas por Luxol Fast Blue através do programa KS400 (Carl Zeiss®). Foram calculados áreas e volumes isquêmicos. RESULTADOS: Estatisticamente, áreas azuis demonstraram diferença entre os grupos C vs. IC, IC vs. IH1 e IC vs. IH2 (p=0,0001; p=0,01; p=0,03), e nenhuma diferença entre C vs. S, IC vs. IH3 e IH vs. IH2 (p=0,39; p=0,85; p=0,63). Áreas vermelhas demonstraram diferença entre C vs. IC, IC vs. IH1 e IC vs. IH2 (p=0,0001; p=0,009; p=0,03), e nenhuma diferença entre C vs. S, IC vs. IH3 e IH1 vs. IH2 (p=0,48; p=0,27; p=0,68). Áreas isquêmicas médias e volumes isquêmicos demonstraram diferença entre os grupos IC vs. IH1 e IC vs. IH2 (p=0,0001 and p=0,0011), e nenhuma diferença entre IC vs. IH3 and IH1 vs. IH2 (p=0,57; p=0,79). CONCLUSÃO: Hipotermias pré-isquêmica e intra-isquêmica demonstraram neuroproteção em grau semelhante, o que não ocorreu com hipotermia pós-isquêmica.


Subject(s)
Animals , Male , Rats , Hypothermia, Induced/methods , Ischemic Attack, Transient/pathology , Reperfusion Injury/prevention & control , Analysis of Variance , Arterial Occlusive Diseases/complications , Body Temperature , Disease Models, Animal , Ischemic Attack, Transient/etiology , Ischemic Attack, Transient/prevention & control , Rats, Wistar , Reperfusion/methods , Sodium Chloride , Statistics, Nonparametric , Time Factors
7.
Arch. cardiol. Méx ; 82(2): 135-138, abr.-jun. 2012. ilus
Article in English | LILACS | ID: lil-657950

ABSTRACT

A 54-year male with previous triple vessel coronary artery and aorto-bifemoral bypass graft surgeries complained of crescent angina. Stress induced myocardial ischemia on echocardiography was demonstrated. We performed direct stenting of a saphenous vein graft to the right coronary artery, via right radial approach. Subsequently stenting of a severe left subclavian artery proximal stenosis was performed via right brachial approach in order to relieve an overt myocardial ischemia in the territory supplied by a patent left internal mammary artery graft originated distally to the left subclavian stenosis. The finding of a total left axillary artery occlusion complement the pathogenesis of myocardial ischemia produced by limited anterograde flow and not driven by the common flow reversal mechanism of a typical coronary-subclavian steal syndrome.


Se trata de un paciente masculino de 54 años de edad, con antecedentes de cirugía de revasuclarización miocárdica por enfermedad coronaria trivascular, así como puentes aortobifemorales. Se presentó en nuestro centro aquejando de angina de pecho, de patrón creciente. Se demostró la existencia de isquemia miocárdica, mediante ecocardiografía con estrés farmacológico. Realizamos una angioplastia con stent a un puente de safena inversa a la coronaria derecha por vía radial derecha. Posteriormente debido a una estenosis proximal severa de la arteria subclavia izquerida, implantamos un stent mediante vía braquial derecha, con la idea de mejorar la isquemia existente en el territorio previamente revascularizado por un puente de arteria mamaria izquierda, que se originaba distalmente a la estenosis de la arteria subclavia. El hallazgo de una oclusión total crónica a nivel de la arteria axilar izquierda completó la patogénesis de la isquemia miocárdica no condicionada por robo al flujo coronario, como tradicionalmente sucede en el síndrome de robo subclavio coronario. En este caso particular, el mecanismo isquémico fue debido al compromiso anterógrado de flujo, provocado por la estenosis severa de la arteria subclavia.


Subject(s)
Humans , Male , Middle Aged , Arterial Occlusive Diseases/complications , Coronary Artery Bypass/adverse effects , Mammary Arteries/transplantation , Myocardial Ischemia/etiology , Subclavian Artery , Coronary-Subclavian Steal Syndrome
8.
Rev. urug. cardiol ; 27(1): 17-27, abr. 2012.
Article in Spanish | LILACS | ID: lil-665287

ABSTRACT

En pacientes con infarto agudo de miocardio con elevación del segmento ST (IAMcST) que han recibido una estrategia de reperfusión, la ausencia de disminución del supradesnivel del ST (resolución del segmento ST) se ha relacionado con un déficit en la perfusión miocárdica. Esto es debido, en parte, a la presencia de injuria tisular por obstrucción microvascular (OMV). El objetivo de este estudio fue analizar el valor del electrocardiograma por medio de la resolución del ST como predictor de OMV, tamaño del infarto y función ventricular izquierda residual. Todos estos parámetros medidos por resonancia magnética cardíaca (RMC). Método: se estudiaron retrospectivamente 33 pacientes con IAMcST, los cuales fueron reperfundidos por medio de angioplastia primaria. A todos estos se les realizó RMC en la fase aguda del infarto. Los cambios del ST (RST) fueron analizados en dos momentos: inmediatamente antes de la angioplastia y 90 minutos después de la misma. Dependiendo, si los cambios del supradesnivel del ST fueron mayores o menores a 50%, los pacientes fueron clasificados en dos grupos. Se valoraron parámetros de la RMC que incluyeron volúmenes ventriculares izquierdos con fracción de eyección, tamaño de infarto, y extensión de la obstrucción microvascular. Resultados: en el grupo con RST (n=19), el tamaño del infarto, el índice de defecto de perfusión y el volumen sistólico final indexado del ventrículo izquierdo fueron significativamente menores que en el grupo sin RST


Subject(s)
Humans , Arterial Occlusive Diseases/complications , Magnetic Resonance Imaging/methods , Myocardial Infarction/physiopathology , Myocardial Infarction/therapy , Microcirculation , Myocardial Reperfusion , Stroke Volume
9.
Braz. j. med. biol. res ; 45(3): 212-215, Mar. 2012. ilus, tab
Article in English | LILACS | ID: lil-618043

ABSTRACT

Agmatine, an endogenous polyamine and putative neuromodulator, is known to have neuroprotective effects on various neurons in the central nervous system. We determined whether or not topically administered agmatine could reduce ischemic retinal injury. Transient ocular ischemia was achieved by intraluminal occlusion of the middle cerebral artery of ddY mice (30-35 g) for 2 h, which is known to also induce occlusion of the ophthalmic artery. In the agmatine group (N = 6), a 1.0 mM agmatine-containing ophthalmic solution was administered four times daily for 2 weeks before occlusion. In the control group (N = 6), a 0.1 percent hyaluronic acid ophthalmic solution was instilled at the same times. At 22 h after reperfusion, the eyeballs were enucleated and the retinal sections were stained by terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL). Transient ocular ischemia induced apoptosis of retinal cells in the entire retinal layer, and topically administered agmatine can significantly reduce this ischemic retinal injury. The proportion of apoptotic cells was definitely decreased (P < 0.001; Kruskal-Wallis test). Overall, we determined that topical agmatine application effectively decreases retinal damage in an in vivo ocular ischemic injury model. This implies that agmatine is a good candidate as a direct neuroprotective agent for eyes with ocular ischemic diseases.


Subject(s)
Animals , Male , Mice , Agmatine/administration & dosage , Arterial Occlusive Diseases/complications , Ischemia/drug therapy , Neuroprotective Agents/administration & dosage , Ophthalmic Artery , Retinal Diseases/drug therapy , Disease Models, Animal , Ischemia/etiology , Retinal Diseases/etiology
10.
Rev. argent. ultrason ; 9(4): 190-194, dic. 2010. ilus
Article in Spanish | LILACS | ID: lil-570755

ABSTRACT

Se detallan los tipos de robos arteriales más frecuentes: robo carotideo tipo I, robo carotideo tipo II, robo subclavio, robo coronario-subclavio, y robo de la fístula arterio-venosa de hemodiálisis al lecho distal.


Subject(s)
Humans , Male , Female , Aortic Diseases , Arterial Occlusive Diseases/classification , Arterial Occlusive Diseases/complications , Arterial Occlusive Diseases/diagnosis , Arterial Occlusive Diseases
11.
Arq. bras. cardiol ; 94(6): 150-178, jun. 2010. tab
Article in English, Portuguese | LILACS | ID: lil-550681

ABSTRACT

Atualmente, a síndrome metabólica (SM) se mostra altamente prevalente, sendo associada a fatores de risco para doenças crônicas não transmissíveis, tais como diabetes mellitus tipo 2, doenças ateroscleróticas e coronarianas. O objetivo desta revisão sistemática foi descrever os resultados de estudos que investigaram a associação da SM com a doença arterial coronariana e doenças vasculares oclusivas. Foi realizada a revisão sistemática com dados de estudos originais publicados entre 1999 e 2008, escritos em inglês ou português, utilizando-se as bases de dados Medline, Pubmed, Highwire Press e Science Direct. Foram incluídos artigos que fizeram o diagnóstico da SM através do critério do National Cholesterol Education Program - Adult Treatment Panel III (NCEP ATP III, 2001). Foram excluídos estudos realizados com animais, de suplementação e que realizaram administração oral ou endovenosa de qualquer substância, assim como aqueles de baixa qualidade metodológica e com amostra inicialmente heterogênea. Apesar da heterogeneidade entre os estudos, observou-se que indivíduos com SM apresentam maior probabilidade (risco = 2,13) de desenvolverem as doenças vasculares oclusivas, doença coronariana, diabetes mellitus e acidente vascular encefálico. Mudanças no estilo de vida, como práticas alimentares saudáveis, atividade física regular e a cessação do tabagismo devem ser incentivadas pelos profissionais da saúde a fim de minimizar as complicações e a morbimortalidade associada à SM.


Nowadays, the metabolic syndrome (MS) is highly prevalent and is associated with risk factors for non-transmissible chronic diseases, such as type 2 diabetes mellitus, and coronary atherosclerotic disease. The objective of this systematic review is to describe the results of studies that investigated the association of MS with coronary artery disease and occlusive vascular diseases. We conducted a systematic review of data from original studies published between 1999 and 2008, written in English or Portuguese, using the databases Medline, Pubmed, Science Direct and HighWire Press. We included articles in which the diagnosis of MS was made by the criteria of the National Cholesterol Education Program - Adult Treatment Panel III (NCEP ATP III, 2001). We excluded studies with animals, supplementation studies, and those with oral or intravenous administration of any substance, as well as those of low methodological quality and those which had a heterogeneous initial sample. Despite the heterogeneity among studies, we observed that individuals with MS had a higher probability (risk = 2.13) of developing occlusive vascular diseases, coronary disease, diabetes and stroke. Lifestyle changes such as healthy eating habits, regular physical activity and cessation of smoking should be encouraged by health professionals to minimize the complications and morbidity associated with MS.


Subject(s)
Humans , Male , Female , Adult , Arterial Occlusive Diseases/complications , Coronary Artery Disease/complications , Metabolic Syndrome/complications , Metabolic Syndrome/diagnosis , Prevalence , Risk Factors
12.
Indian J Pediatr ; 2009 Oct; 76(10): 1053-1055
Article in English | IMSEAR | ID: sea-142403

ABSTRACT

Locked-in syndrome is characterized by upper motor neuron quadriplegia, paralysis of lower cranial nerves, bilateral horizontal gaze palsy and anarthria, with preserved consciousness. It is due to a ventral pontine lesion following a basilar artery occlusion. We report the first Indian case report of locked-in syndrome, a 10-year old girl in whom the syndome was preceded by a ‘herald hemiparesis’. Although the exact etiology for the basilar artery occlusion could not be determined, treatment with low molecular weight heparin and warfarin was followed by partial recovery.


Subject(s)
Arterial Occlusive Diseases/complications , Arterial Occlusive Diseases/diagnosis , Arterial Occlusive Diseases/drug therapy , Basilar Artery/pathology , Child , Female , Follow-Up Studies , Heparin, Low-Molecular-Weight/therapeutic use , Humans , India , Magnetic Resonance Angiography , Neuropsychological Tests , Quadriplegia/diagnosis , Quadriplegia/drug therapy , Quadriplegia/etiology , Rare Diseases , Recovery of Function , Severity of Illness Index , Stroke/complications , Stroke/diagnosis , Stroke/drug therapy , Treatment Outcome , Warfarin/therapeutic use , Arterial Occlusive Diseases/complications , Arterial Occlusive Diseases/diagnosis , Arterial Occlusive Diseases/drug therapy , Basilar Artery/pathology , Child , Female , Follow-Up Studies , Heparin, Low-Molecular-Weight/therapeutic use , Humans , India , Magnetic Resonance Angiography , Neuropsychological Tests , Quadriplegia/diagnosis , Quadriplegia/drug therapy , Quadriplegia/etiology , Rare Diseases , Recovery of Function , Severity of Illness Index , Stroke/complications , Stroke/diagnosis , Stroke/drug therapy , Treatment Outcome , Warfarin/therapeutic use
14.
Säo Paulo med. j ; 125(3): 191-195, May 2007. ilus, tab
Article in English | LILACS | ID: lil-463537

ABSTRACT

Sudden sensorineural hearing loss and vertigo (SSNHLV) has multifactorial causes, of which viral, autoimmune and vascular insufficiency are the most common. The therapeutic management for SSNHLV includes antiviral drugs, corticosteroids, vasodilators, normovolemic hemodilution therapy and hyperbaric oxygen therapy. Vertebrobasilar occlusive disease and carotid occlusive disease are seldom related to SSNHLV. Discussions concerning SSNHLV caused by occlusive vascular disease are important and necessary for both neurologists and otolaryngologists, since their therapeutic management and prognosis are very different from other causes of hearing loss and vertigo. Here, we present our experience with three cases managed with interventional treatment and conduct a review and discussion on the relevant literature. We conclude that investigation of vertebrobasilar and carotid occlusive diseases is necessary in patients over 50 years of age who present SSNHLV, mild neurological symptoms and a history of arteriosclerosis, high blood pressure or thrombosis.


Surdez sensorioneural súbita e vertigem súbita (SSNVS) podem ter múltiplas causas, e a infecção virótica, a doença autoimune e a insuficiência vascular são as mais comuns. O tratamento da SSNVS inclui drogas antiviróticas, corticosteróides, vasodilatores, terapia de hemodiluição normovolêmica e terapia hiperbárica. Raramente são relacionadas como causa a doença vertebrobasilar oclusiva e a doença carotídea oclusiva. Discutir SSNVS é importante e necessário para neurologistas e otolaringologistas, uma vez que a terapia e o prognóstico são muito diferentes conforme a etiologia. Apresentamos nossa experiência com três casos em que foi administrado tratamento intervencional para SSNVS de causa oclusiva em grandes vasos e apresentamos uma revisão e discussão da literatura pertinente. Concluímos que a investigação de doenças oclusivas vertebrobasilar e carotídea é necessária em pacientes acima dos 50 anos de idade com SSNVS, sintomas neurológicos moderados e uma história de arteriosclerose, pressão alta ou trombose.


Subject(s)
Aged , Female , Humans , Male , Middle Aged , Arterial Occlusive Diseases/complications , Hearing Loss, Sensorineural/etiology , Hearing Loss, Sudden/etiology , Vertigo/etiology , Age Factors , Angioplasty , Arterial Occlusive Diseases/diagnosis , Arterial Occlusive Diseases/surgery , Magnetic Resonance Angiography , Risk Factors , Vertebrobasilar Insufficiency/complications
15.
Indian J Physiol Pharmacol ; 2007 Jan-Mar; 51(1): 62-8
Article in English | IMSEAR | ID: sea-108006

ABSTRACT

Involvement of p53 has been implicated in apoptosis induced cell death in ischemic reperfusion injury. In the present study, we have investigated neuroprotective potential of pifithrin-alpha, a p53 inhibitor in bilateral common carotid arteries occlusion (5 min) model of global cerebral ischemia in Mongolian gerbils. Gerbils were treated with pifithrin-alpha 3 mg/kg, ip. 30 min prior to occlusion. There was a significant increase in neurological symptoms and locomotor activity in ischemic animals as compared with the sham-operated animals. Increase in neurological symptoms and locomotor activity was attenuated by pifithrin-alpha 3 mg/ kg, ip. Significant increase in the number of the surviving neurons in the hippocampal CA1 pyramidal region was observed in ischemic animals treated with pifithrin-alpha 3 mg/kg, ip. This study demonstrates the neuroprotective effect of pifithrin-alpha in global cerebral ischemia in gerbils.


Subject(s)
Animals , Arterial Occlusive Diseases/complications , Benzothiazoles/administration & dosage , Brain Ischemia/etiology , Carotid Artery Diseases/complications , Cell Death/drug effects , Cell Survival/drug effects , Gerbillinae , Hippocampus/drug effects , Injections, Intraperitoneal , Male , Motor Activity/drug effects , Neuroprotective Agents/administration & dosage , Pyramidal Cells/drug effects , Reperfusion Injury/etiology , Time Factors , Toluene/administration & dosage
16.
Arq. neuropsiquiatr ; 64(3a): 664-667, set. 2006. ilus
Article in English, Portuguese | LILACS | ID: lil-435609

ABSTRACT

Posterior fossa ischemia is not a very frequent situation. It is responsible for about 25 percent of all ischemic strokes, and the vast majority of the cases are related to atherosclerotic stenosis of the vertebral and/or basilar arteries. Acute ischemia can also occur in the setting of vertebral artery dissection, traumatic or spontaneous. Recently, blunt trauma has been increasingly recognized as a cause for craniocervical artery injury. The management options for both traumatic and atherosclerotic lesions of the posterior fossa are still under debate. We present a case of a delayed onset of hemodynamic ischemic symptoms due to bilateral vertebral artery occlusion probably related to remote trauma to the head and neck in a 55-year-old-man treated successfully with extracranial to intracranial bypass.


Acidentes vasculares cerebrais (AVC) isquêmicos no sistema vertebro-basilar não são frequentes. Representam cerca de 25 por cento dos AVCs isquêmicos, e a maioria é relacionada com aterosclerose das artérias vertebrais e/ou basilar. Isquemia aguda pode também ser resultado de dissecções da artéria vertebral, traumáticas ou espontâneas. Recentemente, traumatismos fechados têm sido cada vez mais reconhecidos como causa de lesão das artérias craniocervicais, podendo ou não resultar em sintomas isquêmicos. O tratamento para estas lesões, sejam traumáticas ou ateroscleróticas, ainda é motivo de debate. Relatamos o caso de um homem de 55 anos com sintomas isquêmicos, hemodinâmicos, tardios, devido a oclusão bilateral das artérias vertebrais, provavelmente relacionada a lesão traumática das artérias vertebrais, tratada com sucesso com bypass extra-intracraniano.


Subject(s)
Humans , Male , Middle Aged , Arterial Occlusive Diseases/surgery , Brain Ischemia/surgery , Cerebral Revascularization/methods , Vertebral Artery , Arterial Occlusive Diseases/complications , Arterial Occlusive Diseases , Brain Ischemia/etiology , Brain Ischemia , Cerebral Angiography , Treatment Outcome
17.
Int. j. morphol ; 24(3): 429-436, sept. 2006.
Article in English | LILACS | ID: lil-474608

ABSTRACT

La presente revisión tiene por objetivo conocer tanto los aspectos anatómicos como clínicos y quirúrgicos relacionados con el síndrome de compresión del tronco celíaco causado por el ligamento arqueado mediano del diafragma. Se revisan los principales descubrimeinos del síndrome, tanto en el plano anatómico durante la disecación de cadáveres, como en la clínica-quirúrgica de la estenosis del tronco celíaco. Además, se revisa la relación de esta estenosis con los síntomas del paciente y cura después de la descompresión del tronco celíaco. Por otra parte, se explican los métodos no invasivos e invasivos utilizados en la descompresión; el efecto estenótico de los mecanismos fisiológicos del desplazamiento del ligamento arqueado mediano, aorta y tronco celíaco durante la respiración; anatomía del canal aórtico y plexo celíaco; el ligamento arqueado mediano y el plexo celíaco como agentes constrictores; la esquelotopía del tronco celíaco y del ligamento arqueado mediano y la predisposición para el síndrome. Finalmente, se hace una asociación del síndrome del tronco celíaco con anomalías morfológicas y metabólicas.


The purpose of the present review is to report the anatomic and the clinical-surgical aspects involved in the celiac trunk compression syndrome by the median arcuate ligament of the diaphragm, reviewing the major findings of the syndrome in the anatomic field during dissection of cadavers, followed by clinical-surgical findings of stenosis of the celiac trunk, the relationship of this stenosis with the patient's symptoms and healing after decompression of that artery; invasive and non-invasive methods used to diagnose compression; the stenotic effect of physiologic mechanisms of the median arcuate ligament, aorta and celiac trunk displacement during respiration; anatomy of the aortic channel and celiac plexus; the median arcuate ligament and the celiac plexus as constrict agents; skeletopy of the celiac trunk, the median arcuate ligament and predisposition to syndrome; association of the syndrome with morphological and metabolic aspects.


Subject(s)
Humans , Celiac Artery/anatomy & histology , Celiac Artery/surgery , Celiac Artery/physiopathology , Celiac Plexus/anatomy & histology , Celiac Plexus/surgery , Celiac Plexus/pathology , Arterial Occlusive Diseases/surgery , Arterial Occlusive Diseases/complications , Diaphragm
18.
Arq. neuropsiquiatr ; 63(3A): 693-696, set. 2005. ilus
Article in Portuguese | LILACS | ID: lil-409060

ABSTRACT

Aneurismas próprios da artéria comunicante posterior são extremamente raros possuindo uma incidência que varia de 0,1 a 2,8 por cento de todos os aneurismas. O surgimento de aneurisma intracraniano em virtude de alterações de fluxo por oclusão arterial é descrito na literatura. Apresentamos o caso de homem de 69 anos, vítima de hemorragia subaracnóidea, com diagnóstico de aneurisma próprio da artéria comunicante posterior direita. Havia também, oclusão da artéria subclávia esquerda com roubo de fluxo da artéria vertebral direita pela vertebral esquerda. Realizou-se tratamento endovascular com angioplastia e colocação de stent na artéria subclávia esquerda com conseqüente oclusão do aneurisma. Discutimos o restabelecimento do fluxo arterial intracraniano como forma de tratamento deste aneurisma.


Subject(s)
Aged , Humans , Male , Arterial Occlusive Diseases/complications , Intracranial Aneurysm/complications , Subclavian Artery , Subarachnoid Hemorrhage/etiology , Angioplasty , Arterial Occlusive Diseases , Arterial Occlusive Diseases/surgery , Cerebral Angiography , Intracranial Aneurysm , Intracranial Aneurysm/surgery , Stents , Subarachnoid Hemorrhage , Subarachnoid Hemorrhage/surgery
19.
Arq. neuropsiquiatr ; 62(3B): 899-902, set. 2004. ilus
Article in English | LILACS | ID: lil-384151

ABSTRACT

Relatamos o caso de uma doente de 36 anos que apresentou oclusão de um aneurisma fusiforme de artéria basilar associado a infarto pontino e dois episódios de hemorragia subaracnóide provavelmente devido a dissecção arterial. Ela também apresentava aneurismas fusiformes assintomáticos na artéria cerebral média direita e na artéria carótida interna esquerda. Ao longo de 5 anos, lesões compatíveis com displasia fibromuscular foram observadas na artéria vertebral direita, assim como oclusão da artéria vertebral esquerda. Esta combinação de lesões sugere que um mecanismo etiopatogênico comum tenha causado diferentes graus de comprometimento da camada média de artérias cervicocranianas.


Subject(s)
Adult , Female , Humans , Arterial Occlusive Diseases/complications , Carotid Artery Diseases/complications , Intracranial Aneurysm/complications , Subarachnoid Hemorrhage/complications , Ticlopidine/analogs & derivatives , Arterial Occlusive Diseases/drug therapy , Arterial Occlusive Diseases , Aspirin/therapeutic use , Basilar Artery , Carotid Artery, Internal , Cerebral Angiography , Carotid Artery Diseases/drug therapy , Carotid Artery Diseases , Intracranial Aneurysm/drug therapy , Intracranial Aneurysm , Platelet Aggregation Inhibitors/therapeutic use , Subarachnoid Hemorrhage/drug therapy , Subarachnoid Hemorrhage , Ticlopidine/therapeutic use
20.
Article in English | IMSEAR | ID: sea-91964

ABSTRACT

We report the case of a young man with anterior inferior cerebellar artery infarct causing unilateral deafness. Clinical features and audiometry suggested cochlear localization for deafness. MRI brain showed an infarct in the right AICA territory with involvement of pons. Involvement of the internal auditory artery explains the cochlear deafness.


Subject(s)
Adult , Arterial Occlusive Diseases/complications , Cerebellum/blood supply , Cerebral Angiography , Hearing Loss, Sudden/diagnosis , Hearing Loss, Unilateral/diagnosis , Humans , Infarction, Anterior Cerebral Artery/complications , Magnetic Resonance Imaging , Male , Pons/blood supply
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