ABSTRACT
La enfermedad cerebrovascular aguda se distingue como causa frecuente de ingreso hospitalario por urgencia neurológica. Se realizó un estudio descriptivo prospectivo de pacientes con el diagnóstico de enfermedad cerebrovascular aguda de causa hipertensiva, que ingresaron en el Hospital General Universitario Carlos Manuel de Céspedes de Bayamo en el período de abril a noviembre del 2014 con el objetivo de realizar la caracterización tomográfica de la entidad acorde al diagnóstico clínico. La muestra estuvo constituida por 83 casos. Se aplicaron métodos teóricos como el inductivo deductivo y el análisis síntesis. Se determinaron frecuencias absolutas y relativas. El 57.9 por ciento ingresó con el diagnóstico clínico de Infarto Cerebral Isquémico. El diagnóstico post tomografía aportó predominio del Infarto Cerebral Isquémico en el 27.7 por ciento seguido de la Hemorragia Intraparenquimatosa. Existió correspondencia clínico tomográfica en 54.2 por ciento de la muestra. Dentro de los hallazgos tomográficos predominó la dilatación ventricular. Se evidenció la utilidad de la tomografía en la precisión diagnóstica y el seguimiento de los casos(AU)
Acute cerebrovascular disease is distinguished as a frequent cause of hospitalization by neurological emergency. It was carried out a descriptive prospective study of patients with the diagnosis of acute cerebrovascular disease derived from hypertension that was admitted in Carlos Manuel de Céspedes hospital in Bayamo in the period April to November 2014, with the objective to perform the tomography characterization according to the clinical diagnostic. The sample consisted of 83 cases. Theoretical methods such as inductive deductive and synthesis analysis were applied. Absolute and relative frequencies were determined. The 57.9 percent were admitted with the clinical diagnostic of cerebral ischemic attack. The post tomography diagnostic contributed prevailing in 27.7 percent of the cerebral ischemic attack followed by the intraparenchymal hemorrhage. There was clinical tomography correspondence in the 54.2 percent of the samples. Within the tomography findings the ventricular dilatation was predominated. The tomography usefulness in the precision diagnostic and the follow-up of the cases were evidenced(EU)
Subject(s)
Humans , Cerebrovascular Disorders/etiology , Hypertension/complications , Cerebral Infarction/diagnosis , Intracranial Hemorrhage, Hypertensive/diagnosis , Tomography, X-Ray Computed , Epidemiology, Descriptive , Prospective StudiesABSTRACT
Type I collagen (transcribed by COL1A1 and COL1A2 genes) is important for maintaining vessel wall elasticity and is a critical part of the extracellular matrix. We conducted a case-control study to investigate the role of the COL1A2 rs42524 polymorphism in the development of hypertensive intracerebral hemorrhage. Between January 2012 and December 2014, a total of 227 patients with hypertensive intracerebral hemorrhage and 227 controls were selected from the Affiliated Hospital of Yanan University (China). Genotyping of the COL1A2 rs42524 polymorphism was performed using polymerase chain reaction coupled with restriction fragment length polymorphism. By logistic regression analysis, we found that the CC genotype was associated with increased risk of hypertensive intracerebral hemorrhage as compared to the GG genotype (OR = 12.67, 95%CI = 3.03-112.11). In a dominant model, the GC + CC genotype of the COL1A2 rs42524 polymorphism was associated with a 2.57-fold increased risk of hypertensive intracerebral hemorrhage as compared to the GG genotype. In a recessive model, the CC genotype of the COL1A2 rs42524 polymorphism was correlated with a higher risk of hypertensive intracerebral hemorrhage as compared to the GG + GC genotype (OR = 12.07, 95%CI = 2.89-106.75). The GC and CC genotypes of the COL1A2 rs42524 polymorphism were associated with a substantial risk of hypertensive intracerebral hemorrhage among patients who consumed alcohol and used tobacco. In conclusion, our study suggests that the COL1A2 rs42524 polymorphism is associated with the development of hypertensive intracerebral hemorrhage, particularly in conjunction with tobacco use and alcohol consumption.
Subject(s)
Collagen Type I/genetics , Intracranial Hemorrhage, Hypertensive/genetics , Aged , Asian People/genetics , Case-Control Studies , China , Female , Genetic Predisposition to Disease/genetics , Genotype , Humans , Incidence , Male , Middle Aged , Polymorphism, Single Nucleotide/geneticsABSTRACT
La enfermedad cerebrovascular aguda se distingue como causa frecuente de ingreso hospitalario por urgencia neurológica. Se realizó un estudio descriptivo prospectivo de pacientes con el diagnóstico de enfermedad cerebrovascular aguda de causa hipertensiva, que ingresaron en el Hospital General Universitario Carlos Manuel de Céspedes de Bayamo en el período de abril a noviembre del 2014 con el objetivo de realizar la caracterización tomográfica de la entidad acorde al diagnóstico clínico. La muestra estuvo constituida por 83 casos. Se aplicaron métodos teóricos como el inductivo deductivo y el análisis síntesis. Se determinaron frecuencias absolutas y relativas. El 57.9 por ciento ingresó con el diagnóstico clínico de Infarto Cerebral Isquémico. El diagnóstico posttomografía aportó predominio del Infarto Cerebral Isquémico en el 27.7 por ciento seguido de la Hemorragia Intraparenquimatosa. Existió correspondencia clínico tomográfica en 54.2 por ciento de la muestra. Dentro de los hallazgos tomográficos predominó la dilatación ventricular. Se evidenció la utilidad de la tomografía en la precisión diagnóstica y el seguimiento de los casos(AU)
Acute cerebrovascular disease is distinguished as a frequent cause of hospitalization by neurological emergency. It was carried out a descriptive prospective study of patients with the diagnosis of acute cerebrovascular disease derived from hypertension that was admitted in Carlos Manuel de Céspedes hospital in Bayamo in the period April to November2014, with the objective to perform the tomography characterization according to the clinical diagnostic. The sample consisted of 83 cases. Theoretical methods such as inductive deductive and synthesis analysis were applied. Absolute and relative frequencies were determined. The 57.9 percent were admitted with the clinical diagnostic of cerebral ischemic attack. The post tomography diagnostic contributed prevailing in 27.7 percent of the cerebral ischemic attack followed by the intraparenchymal hemorrhage. There was clinical tomography correspondence in the 54.2 percent of the samples. Within the tomography findings the ventricular dilatation was predominated. The tomography usefulness in the precision diagnostic and the follow-up of the cases were evidenced(EU)
Subject(s)
Humans , Male , Female , Cerebrovascular Disorders/etiology , Hypertension/complications , Cerebral Infarction/diagnosis , Intracranial Hemorrhage, Hypertensive/diagnosis , Tomography, X-Ray Computed , Epidemiology, Descriptive , Prospective StudiesABSTRACT
Changes in socio-emotional behavior and conduct, which are characteristic symptoms of frontal lobe damage, have less often been described in patients with focal subcortical injuries. We report on a case of pathological generosity secondary to a left lenticulocapsular stroke with hypoperfusion of several anatomically intact cortical areas. A 49-year-old man developed excessive and persistent generosity as he recovered from a left lenticulocapsular hematoma. His symptoms resembled an impulse control disorder. (99m)Tc-HMPAO SPECT demonstrated hypoperfusion mostly in the ipsilateral striatum, dorsolateral, and orbitofrontal cortex. This case study adds pathological generosity to the range of behavioral changes that may result from discrete unilateral lesions of the lenticular nucleus and nearby pathways. In our particular case, post-stroke pathological generosity was not ascribable to disinhibition, apathy, mania, or depression. Because pathological generosity may lead to significant distress and financial burden upon patients and their families, it may warrant further consideration as a potential type of impulse control disorder.
Subject(s)
Disruptive, Impulse Control, and Conduct Disorders/etiology , Intracranial Hemorrhage, Hypertensive/complications , Stroke/complications , Corpus Striatum/pathology , Humans , Male , Middle AgedSubject(s)
Antihypertensive Agents/adverse effects , Blood Pressure/physiology , Hypertension/drug therapy , Intracranial Hemorrhage, Hypertensive/complications , Piperazines/adverse effects , Antihypertensive Agents/pharmacology , Antihypertensive Agents/therapeutic use , Blood Pressure/drug effects , Humans , Hypertension/physiopathology , Multicenter Studies as Topic , Piperazines/pharmacology , Piperazines/therapeutic use , Randomized Controlled Trials as Topic , Time Factors , Treatment OutcomeABSTRACT
PURPOSE: To compare curative effect of different treatments for hypertensive cerebral hemorrhage of 25 to 35 ml. METHODS: In this study, 595 cases were enrolled and grouped regarding treatments including conservative treatment, evacuation with microinvasive craniopuncture technique within 6h and 6-48 h after the attack. RESULTS: After follow up for three months after the attack, the assessment based on the Activity of Daily Living (ADL) indicated no significant difference among conservative treatment and surgical interventions (p>0.05). However, surgical interventions showed advantages of shorter hospitalization, quick removal of hematoma and obvious reduction of cost. CONCLUSION: The microinvasive craniopuncture technique to drain the hematoma within 6-48 h may be a good way in treating hypertensive hemorrhage of basal ganglia region.
Subject(s)
Basal Ganglia Hemorrhage/therapy , Basal Ganglia/surgery , Intracranial Hemorrhage, Hypertensive/therapy , Neurosurgical Procedures/methods , Adult , Aged , Basal Ganglia/pathology , Basal Ganglia Hemorrhage/pathology , Chi-Square Distribution , Female , Hematoma/surgery , Humans , Length of Stay , Male , Middle Aged , Punctures/methods , Time Factors , Treatment OutcomeABSTRACT
PURPOSE: To compare curative effect of different treatments for hypertensive cerebral hemorrhage of 25 to 35ml. METHODS: In this study, 595 cases were enrolled and grouped regarding treatments including conservative treatment, evacuation with microinvasive craniopuncture technique within 6h and 6-48h after the attack. RESULTS: After follow up for three months after the attack, the assessment based on the Activity of Daily Living (ADL) indicated no significant difference among conservative treatment and surgical interventions (p>0.05). However, surgical interventions showed advantages of shorter hospitalization, quick removal of hematoma and obvious reduction of cost. CONCLUSION: The microinvasive craniopuncture technique to drain the hematoma within 6-48h may be a good way in treating hypertensive hemorrhage of basal ganglia region.
OBJETIVO: Comparar o efeito curativo de diferentes tratamentos da hemorragia hipertensiva cerebral de 25 a 35ml. MÉTODOS: Foram analisados 595 casos agrupados segundo tratamento conservador e evacuação com técnica de punção transcraniana dentro de 6h ou de 6 às 48h do início do quadro clínico. RESULTADOS: O seguimento após três meses e avaliado pelo Escore de Atividade de Vida Diário, indicou que não houve diferenças significantes entre os tratamentos conservador e cirúrgico (p>0.05) O tratamento cirúrgico mostrou vantagem com hospitalização mais curta e redução de custos. CONCLUSÃO: A técnica de punção transcraniana para drenagem de hematoma dos núcleos da base pode ser uma boa alternativa de tratamento.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Basal Ganglia Hemorrhage/therapy , Basal Ganglia/surgery , Intracranial Hemorrhage, Hypertensive/therapy , Neurosurgical Procedures/methods , Basal Ganglia Hemorrhage/pathology , Basal Ganglia/pathology , Chi-Square Distribution , Hematoma/surgery , Length of Stay , Punctures/methods , Time Factors , Treatment OutcomeABSTRACT
La craniectomía decompresiva (CD) es una maniobra quirúrgica de salvataje que debe ser oportunamente indicada y correctamente hecha. Su uso se remonta a la más antigua historia de la neurocirugía. En la actualidad indicar una craniectomía decompresiva, supone generalmente una hipertensión endocraneana de evolución maligna, o sea que ha existido refractariedad a todas las medidas médicas de primer nivel correctamente instituidas (CD secundaria). Otras veces se realiza en casos en que el cerebro permanece muy hinchado después de cirugía de emergencia, ya sea por hematoma subdural o contusiones cerebrales (CD primaria). Lo que no ha sido bien establecido en la literatura es el reconocimiento de toda la gama de complicaciones inducidas por la CD, las cuales muchas veces condicionarán el pronóstico. Los autores realizan una enumeración y descripción de las complicaciones de la CD, intentando una sistematización y ordenamiento de las mismas y sus posibles soluciones terapéuticas.
Subject(s)
Humans , Craniotomy , Decompression, Surgical , Intracranial Hemorrhage, Hypertensive , Intracranial Hypertension , Postoperative Complications , Brain Ischemia , Cerebrospinal Fluid , Hematoma , Hydrocephalus , Hypotension , Surgical Wound InfectionABSTRACT
PURPOSE: To evaluate the effect of Rut-bpy (Cis-[Ru(bpy)2(SO3)(NO)]PF 6), a novel nitric oxide donor in Nω-nitro-L-arginine methyl ester (L-NAME)-induced hypertensive rats. METHODS: Twenty-four male Wistar rats were randomly assigned to four groups (n=6), named according to the treatment applied (G1-Saline, G2-Rut-bpy, G3-L-NAME and G4-L-NAME+Rut-bpy). L-NAME (30 mg/Kg) was injected intraperitoneally 30 minutes before the administration of Rut-bpy (100 mg/Kg). Mean abdominal aorta arterial blood pressure (MAP) was continuously monitored. RESULTS: Mean arterial blood pressure (MAP) in G3 rats rose progressively, reaching 147±16 mmHg compared with 100±19 mm Hg in G1 rats (p<0.05). In G4 rats, treated with L-NAME+Rut-bpy, MAP reached 149+11 mm Hg while in G2 rats, treated with Rut-bpy, MAP values were 106±11 mm Hg. In G1 rats these values decreased progressively reaching 87+14 mm Hg after 30 minutes. An important finding was the maintenance of the MAP throughout the experiment in G2 rats. CONCLUSION: Rut-bpy does not decrease the MAP in L-Name induced hypertensive rats. However, when it is used in anesthetized hypotensive rats a stable blood pressure is obtained.(AU)
OBJETIVO: Avaliar o efeitos do Rut-bpy (Cis-[Ru (bpy)2(SO3)(NO)] PF6), um novo doador de óxido nítrico, em ratos hipertensos induzidos pelo éster metílico de N-nitro-L-arginina (L-NAME). MÉTODOS: Vinte e quatro ratos Wistar machos foram distribuídos aleatoriamente em quatro grupos (n = 6), nomeados de acordo com o tratamento aplicado (G1-Salina, G2-Rut-bpy, G3-L-NAME e G4-L-NAME+Rut -bpy). L-NAME (30 mg / Kg) foi injetado por via intraperitoneal 30 minutos antes da administração de Rut-bpy (100 mg / kg). A pressão arterial média (PAM) da aorta abdominal foi monitorada continuamente. RESULTADOS: A pressão arterial média (PAM) em ratos do grupo G3 subiu progressivamente, chegando a 147 ±16 mm Hg, em comparação com 100 ±19 mm Hg em ratos do G1 (p <0,05). Em ratos G4, tratados com L-NAME + Rut-bpy, a PAM atingiu 149±11 milímetros de Hg, enquanto no G2 (ratos tratados com Rut bpy) os valores da PAM foram 106 ±11 mm Hg. No G1 esses valores decresceram progressivamente, atingindo 87±14 mm Hg após 30 minutos. Um achado importante foi a manutenção da PAM durante todo o experimento em ratos do grupo G2. CONCLUSÃO: O uso de Rut bpy não diminui a PAM em ratos hipertensos por L-NAME. No entanto, quando ele é usado em ratos anestesiados, hipotensos, uma pressão arterial estável é obtida.(AU)
Subject(s)
Animals , Intracranial Hemorrhage, Hypertensive/chemically induced , Rats/classification , Nitric Oxide/chemistry , Ruthenium/chemistryABSTRACT
BACKGROUND: Obstructive sleep apnea (OSA) is related to increased systemic inflammation and arterial hypertension. We hypothesize that OSA is frequent in patients with acute hypertensive intracerebral hemorrhage (ICH) and is related to the perihematoma edema. METHODS: Thirty-two non-comatose patients with a hypertensive ICH underwent polysomnography in the acute phase. Perihematoma edema volume was measured on CT scans at admission, after 24 h (early control) and after 4-5 days (late control). The Spearman coefficient (r(s)) was used for correlations. RESULTS: OSA occurred in 19 (59.4%) patients. The apnea-hypopnea index was correlated with relative edema at admission CT (r(s) = 0.40; p = 0.031), early CT (r(s) = 0.46; p = 0.011) and at late CT (r(s) = 0.59; p = 0.006). CONCLUSIONS: OSA is highly frequent during the acute phase of hypertensive ICH and is related to perihematoma edema.
Subject(s)
Brain Edema/etiology , Hematoma/etiology , Intracranial Hemorrhage, Hypertensive/complications , Sleep Apnea, Obstructive/etiology , Acute Disease , Aged , Brain Edema/diagnostic imaging , Female , Hematoma/diagnostic imaging , Humans , Intracranial Hemorrhage, Hypertensive/diagnostic imaging , Logistic Models , Male , Middle Aged , Odds Ratio , Polysomnography , Prospective Studies , Risk Assessment , Risk Factors , Severity of Illness Index , Sleep Apnea, Obstructive/diagnosis , Time Factors , Tomography, X-Ray ComputedABSTRACT
Hemorrhage in regions remote from the site of initial intracranial operations is rare, but may be fatal. Postoperative cerebellar hemorrhage as a complication of supratentorial surgery, with a radiological appearance known as zebra sign, is an increasingly recognized clinical entity and is associated mainly with vascular neurosurgery or temporal lobe resection. The pathophysiology remains unclear. Three cases of remote cerebellar hematoma occurred after neck clipping of anterior communicating artery aneurysms. All patients had similar clinical findings and underwent pterional craniotomy with the head in accentuated extension. One patient died and the two were discharged without symptoms. Cerebellar hemorrhage probably has a multifactorial origin involving positioning associated with abundant cerebrospinal fluid drainage causing cerebellar sag with resultant vein stretching and bleeding, and use of aspirin or other antiplatelet agents.
Subject(s)
Cerebellum/physiopathology , Intracranial Hemorrhages/etiology , Intracranial Hemorrhages/physiopathology , Neurosurgical Procedures/adverse effects , Postoperative Hemorrhage/etiology , Postoperative Hemorrhage/physiopathology , Aged , Cerebellar Diseases/etiology , Cerebellar Diseases/physiopathology , Cerebellum/blood supply , Cerebellum/pathology , Cerebral Angiography , Cerebral Veins/diagnostic imaging , Cerebral Veins/pathology , Cerebral Veins/physiopathology , Craniotomy/adverse effects , Fatal Outcome , Female , Humans , Hypotension, Orthostatic/complications , Hypotension, Orthostatic/physiopathology , Iatrogenic Disease , Intracranial Aneurysm/diagnostic imaging , Intracranial Aneurysm/pathology , Intracranial Aneurysm/surgery , Intracranial Hemorrhage, Hypertensive/diagnostic imaging , Intracranial Hemorrhage, Hypertensive/etiology , Intracranial Hemorrhage, Hypertensive/physiopathology , Intracranial Hemorrhages/diagnostic imaging , Intracranial Hypotension/complications , Intracranial Hypotension/physiopathology , Intraoperative Care/adverse effects , Middle Aged , Platelet Aggregation Inhibitors/adverse effects , Tomography, X-Ray Computed , Vascular Surgical Procedures/adverse effects , Ventriculostomy/adverse effectsABSTRACT
Se realizó un estudio descriptivo y prospectivo de los pacientes hipertensos con diagnóstico de infarto cerebral lagunar o de hemorragia profunda primaria en fase aguda que fueron atendidos en la Unidad de Cuidados Intermedios y en el Servicio de Neurología del Hospital Provincial Universitario Arnaldo Milián Castro durante el período comprendido entre el 1 de julio de 2000 hasta el 30 de junio de 2001. Nos propusimos comparar los factores de riesgo cerebrovascular, la localización de las lesiones y el pronóstico entre pacientes hipertensos con infarto cerebral lagunar y con hemorragia intracerebral profunda primaria, y la relación de estos factores en la situación funcional al egreso y en la mortalidad. Para el análisis estadístico se creó una base de datos a partir de los resultados obtenidos en el modelo de recogida de datos(AU)
Subject(s)
Humans , Adult , Hypertension , Cerebral Infarction , Intracranial Hemorrhage, HypertensiveABSTRACT
La hipertensión arterial (HA) está asociada a una variedad de diferentes enfermedades neurológicas de orígen vascular, las cuales pueden ser bien evaluadas con diferentes y avanzados métodos de neuroimágenes. A continuación se analizará brevemente, mostrando algunos ejemplos, diferentes entidades asociadas a la HA que afectan al cerebro, como la leukoaraiosis, micro-hemorragias cerebrales, infartos lacunares, enfermedad de grandes vasos cerebrovasculares, rescate del infarto cerebral agudo así como también se revisarán ejemplos de disección arterial, aneurismas cerebrales y eclampsia. Por último, hay interesantes nuevos trabajos sobre la compresión neurovascular ventrolateral de la médula oblongata como causante de la HA.
Subject(s)
Humans , Hypertension/complications , Cerebrovascular Disorders/classification , Cerebrovascular Disorders/etiology , Cerebral Infarction , Diagnostic Imaging , Intracranial Hemorrhage, HypertensiveABSTRACT
La enfermedad cerebrovascular constituye la tercera causa de muerte en Cuba, con una incidencia de 150-200 por cada 100 000 habitantes. Dentro de ella la hemorragia intraparenquimatosa abarca del 10-15 por ciento. Un estudio descriptivo retrospectivo de 111 pacientes con el diagnóstico de hemeorragia intraparenquimatosa, con o sin comunicación al espacio subaracnoideo y/o sistema ventricular, arroja interesantes datos sobre la etilogía más frecuente de esta patologia(AU)
Subject(s)
Humans , Cerebral Hemorrhage/etiology , Intracranial Hemorrhage, Hypertensive , Hematoma , HypertensionABSTRACT
La enfermedad cerebrovascular constituye la tercera causa de muerte en Cuba, con una incidencia de 150-200 por cada 100 000 habitantes. Dentro de ella la hemorragia intraparenquimatosa abarca del 10-15 por ciento. Un estudio descriptivo retrospectivo de 111 pacientes con el diagnóstico de hemeorragia intraparenquimatosa, con o sin comunicación al espacio subaracnoideo y/o sistema ventricular, arroja interesantes datos sobre la etilogía más frecuente de esta patologia
Subject(s)
Humans , Cerebral Hemorrhage , Hematoma , Hypertension , Intracranial Hemorrhage, HypertensiveABSTRACT
La alta prevalencia de la hipertensión arterial en Cuba, y el alto grado de incapacidad funcional y secuelas que provocan los accidentes vasculares encefálicos hemorrágicos causados por esta, constituyeron los factores fundamentales que motivaron la realización de esta investigación, cuyo objetivo fundamental es demostrar el valor predictivo del comando volumen de la tomografía axial computadorizada (poco utilizado en la práctica cotidiana) en la hemorragia intracerebral hipertensiva, determinando si el volumen de la hemorragia se encuentra relacionado con el cuadro clínico inicial y la calidad de vida del paciente a los 2 meses de evolución. Para ello se estudiaron 85 pacientes con el diagnóstico tomográfico de hemorragia intracerebral de causa hipertensiva. Primeramente, se registró el volumen de la hemorragia calculado por el Software del Somaton CR, además del efecto de masa y la localización de la lesión. Posteriormente, se recogieron de la historia clínica el cuadro neurológico inicial y la evolución clínica a los 2 meses, se utilizó para ello la escala de Karnofsky que valora la calidad de vida en estos pacientes. Se observó que el 62,4 por ciento de los pacientes tenía más de 60 años de edad; en este grupo etáreo a mayor volumen medido, el efecto de masa y el deterioro neurológico fueron mayores, resultados que fueron más significativos en las hemorragias de los núcleos basales. El 100 por ciento de los fallecidos con hemorragias lobares y núcleos basales presentaron volúmenes mayores o iguales a 25 cc, con baja puntuación en la escala de Glasgow (0 a 13). Se demostró que a mayor volumen de la hemorragia la calidad de vida era peor, por lo que se concluyó que el comando volumen posee gran valor pronóstico, al permitir trazar el nivel de calidad de vida a los 2 meses según valores promedio del volumen para cada localización(AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Hypertension/complications , Tomography, X-Ray Computed/methods , Karnofsky Performance Status , Glasgow Coma Scale , Quality of Life , Intracranial Hemorrhage, Hypertensive/etiology , Intracranial Hemorrhage, Hypertensive , Intracranial Hemorrhage, Hypertensive/complicationsABSTRACT
BACKGROUND: Brain injury may induce hypertension. Because serum ouabain-like compound (OLC) has vasoconstrictor activity, digoxin antibody antihypertensive effects were evaluated using an intracerebroventricular (ICV) hemorrhage rat model. METHODS: Four ICV infused Wistar rat groups were studied: control; blood; blood plus digoxin antibody, and cerebrospinal fluid-like solution. Tail-cuff blood pressure, cumulative sodium balance, and serum OLC were measured. RESULTS: The ICV blood infusion increased blood pressure (BP) and OLC without sodium balance change. Digoxin antibody prevented BP and OLC rise. Blood pressure was positively correlated with OLC in blood and blood plus digoxin antibody rats (R = 0.63; P <.05). CONCLUSIONS: Cerebral hemorrhage increased OLC and BP, which were reversed by digoxin antibody administration.
Subject(s)
Antibodies/administration & dosage , Digoxin/immunology , Immunoglobulin Fab Fragments/administration & dosage , Intracranial Hemorrhage, Hypertensive/prevention & control , Saponins/immunology , Sodium-Potassium-Exchanging ATPase/antagonists & inhibitors , Animals , Blood Pressure/drug effects , Brain Injuries/complications , Cardenolides , Infusions, Parenteral , Intracranial Hemorrhage, Hypertensive/etiology , Intracranial Hemorrhage, Hypertensive/physiopathology , Male , Models, Animal , Rats , Rats, WistarABSTRACT
La alta prevalencia de la hipertensión arterial en Cuba, y el alto grado de incapacidad funcional y secuelas que provocan los accidentes vasculares encefálicos hemorrágicos causados por esta, constituyeron los factores fundamentales que motivaron la realización de esta investigación, cuyo objetivo fundamental es demostrar el valor predictivo del comando volumen de la tomografía axial computadorizada (poco utilizado en la práctica cotidiana) en la hemorragia intracerebral hipertensiva, determinando si el volumen de la hemorragia se encuentra relacionado con el cuadro clínico inicial y la calidad de vida del paciente a los 2 meses de evolución. Para ello se estudiaron 85 pacientes con el diagnóstico tomográfico de hemorragia intracerebral de causa hipertensiva. Primeramente, se registró el volumen de la hemorragia calculado por el Software del Somaton CR, además del efecto de masa y la localización de la lesión. Posteriormente, se recogieron de la historia clínica el cuadro neurológico inicial y la evolución clínica a los 2 meses, se utilizó para ello la escala de Karnofsky que valora la calidad de vida en estos pacientes. Se observó que el 62,4 por ciento de los pacientes tenía más de 60 años de edad; en este grupo etáreo a mayor volumen medido, el efecto de masa y el deterioro neurológico fueron mayores, resultados que fueron más significativos en las hemorragias de los núcleos basales. El 100 por ciento de los fallecidos con hemorragias lobares y núcleos basales presentaron volúmenes mayores o iguales a 25 cc, con baja puntuación en la escala de Glasgow (0 a 13). Se demostró que a mayor volumen de la hemorragia la calidad de vida era peor, por lo que se concluyó que el comando volumen posee gran valor pronóstico, al permitir trazar el nivel de calidad de vida a los 2 meses según valores promedio del volumen para cada localización
Subject(s)
Humans , Male , Adult , Female , Middle Aged , Glasgow Coma Scale , Hypertension/complications , Intracranial Hemorrhage, Hypertensive , Karnofsky Performance Status , Quality of Life , Tomography, X-Ray Computed/methodsABSTRACT
PURPOSE: The authors present a prospective study on 10 patients with stereotactic infusion of tissue plasminogen activator (rtPA) intraparenchimal hemorrhage. METHODS: Between 1999 and 2000, 10 patients with deep seated hematomas in the basal ganglia were selected for stereotactic infusion of rtPA and spontaneous clot drainage. RESULTS: All cases had about 80% reduction of the hematoma volume in the CT scan at the third day. The intracranial pressure was normalized by the third day too. There were no local or systemic complications with the use of this thrombolytic. The results were shown by the Glasgow Outcome Scale with six patients in V, three in IV and one in III after 3 months. CONCLUSION: Early treatment and drainage with minimally invasive neurosurgery, can make these patients with deep-seated hematomas recover the consciousness and they can be rehabilitated earlier avoiding secondary complications.